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KMID : 0388719940010010066
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Journal of Korean Society of Spine Surgery
1994 Volume.1 No. 1 p.66 ~ p.73
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Lumbar Intervertebral Disc: A Histologic, Radiologic and Clinical Correlations based on over 95 Discectomies
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나화엽
김영태/안형선/김기용
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Abstract
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Although a few reports have described the histopathologic findings of the removed disc material after lumbar discectomy, the interrelationship of the histologic, radiologic and clinical findings is rarely recognized. We performed a retrospective
histopathologic, radiographic and clinical review of the results for patients who had a discectomy for the treatment of herniated lumbar intervertebral disc to find out any prognostic factors. We analysed ninety five patients who had been treated
by
partial laminectomy and discectomy for intervertebral disc herniation from Jun. 1989 to Apr. 1992 at Department of Orthopedic Surgery, Asan Medical Center. The mean follow up duration was 18 months(range, 12-36 months).
@ES The results were as follows:
@EN In 69 histopathological studies, all cases included the component of annulus fibrosus, but none of them contained the component of nucleus pulposus alone. An avulsion type of the herniated disc materials composed of cartilage end plate and
annulus
fibrosus was 62% (43/69) fo the cases, and we could not find any statistically significant correlation between age and the incidences of avulsion type, but we could find a statistically significant correlation between types on preoperative
magnetic
resonance imaging and the incidences of avulsion type(p<0.05). That is to say, avulsion type was significantly more common in non-contained type than contained type.
2. The space-occupying ratio of herniated disc mass to spinal canal averaged 34.3%, and it was correlated with the weight of removed disc material(p<0.05), but not with the postoperative clinical results.
3. The reduction of the heights of operated disc levels at the latest follow-up radiograph in comparison with preoperative radiograph averaged 5.1%, and this postoperative disc height change did not have any statistically significant-correlation
with
either weight of removed disc material or clinical results.
4. The weight of removed disc material averaged 1.6 grams per level, and it didn't show any statistically significant correlation with the postoperatively clinical results. That is to say, the more increased weight of removed disc material didn'
guarantee the better clinical results.
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