L'ernia discale lombare: la storia e l'evoluzione del trattamento chirurgico.

In the history of surgery lumbar herniectomy has a relatively recent appearance; moreover at the beginning of the 20th century neurosurgeons and orthopedic surgeons performed posterior laminectomy in the presence of severe neurological damage, finding tissues that have been mostly labeled as tumors. Only at the middle of the century the prolapse of the nucleus pulposus was recognized as the most frequent cause of roots compression. Techniques for removing the compression after a large laminectomy have been progressively improved so as radiological methods of locating precisely the exact position of the hernia (MIR). In accordance with these developments also the surgical procedure of removing the cause of the root compression did improve as the microdiscectomy. As all surgical procedures herniectomy may have complications and it is very important to prevent them adopting radiological control on the operating table to prevent space mistake, and checking the absence of abdominal compression to avoid excessive intraoperative bleeding. In spite of approximately more than 90% of satisfactory results, the possibility of a high percentage of spontaneous relief of symptoms in the first six months means that the surgical treatment must be adopted in very selected cases during this period. [ABSTRACT FROM AUTHOR]