[Microsurgery in lumbar disk operations. Possibilities, methods and results].

Abstract

The frequency of lumbar disc hemiation amounts to 5.1% with the male and 3.7% with the female population. Because of the often long-time pain-conditional impairment of the patients as well as the varied therapy-possibilities, the treatment of the ruptured lumbar intervertebral disc represents a special challenge. The indication to the operation for the lumbar disk-herniation results from the malfunctions of the nerve roots, the pains, as well as the temporal course of the symptoms. New and important developments have given the introduction of micro-surgical operation-techniques into the orthopedics. This development has led to it that many orthopedists and neurosurgeons the micro-surgical operation-technique prefers. Important for the micro-surgical lumbar discectomy is the operation-microscope, a good preoperative diagnostics as well as a particular micro-surgical operation-instrument. Through the different enlargement-possibilities of the operation-microscope, all anatomical structures can increase and are done visibly for the surgeon as well as the assistant. Intraoperative injuries of the dura as well as the spinal-nerves are certainly avoided hereby. The micro-surgical discectomie requires no longer time like the conventional operation of the disk. The postoperative stay in the hospital as well as the time of the work-incompetence is reduced. Postoperative inflammations of the disk-area as well as renewed operations are rarer with the microchirurgischen technique. If an operation is necessary, so this should not be out-hesitated too long in order to avoid bed results.