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추간판탈출증 1,5000수술례의 임상적 관찰 A Clinical Study of Intervertebral Disc Surgery Based on 1500 Ca es

대한신경외과학회지 1973년 2권 1호 p.71 ~ 82
김영수,
소속 상세정보
김영수 (  ) 
연세대학교 의과대학 신경과학교실

Abstract


Intervertebral disc disease, encountered in term of its life history, represents on !of the most complexing medicosurgical disorders. The discovery by Mixter and Barr in 1934, that an intraspinal protrusion of the intervertebral disc was sometimes the cause of lumbago and sciatica, was outstandingly important because ; it might provide a rational for the treatment of backache.
The author has reviewed 1500 cases of disc surgery performed at Yonsei University, Sceverance Hospital froth: 1950 to 1971.
A contrast myelography was carried out routinely and the dye was attempted to remove as much as possible. Surgical treatment was underwent by.laminectomy, partial hemi-or total, for the´, thoracic and lumbar discs and Cloward´s anterior approach for cervical discs invariably.
conclusion
1. Among the 1500 disc surgeries 90.2% were lumbar disc lesions; thoracic 0.1%;and cervical 9.7% The percentile of disc herniation between L4-5 vertebrae was 62%; 27%o between L5-S1 vertebrae. 24% of lumbar intervertebral disc herniations disclosed multiple lesions. C5-6 disc herniat ion was 58% and C6-7 lesion 27%, multiple cervical disc herniation was 27%
2. A contrast myelography is an invaluable procedure for the diagnosis of a herniation of the nucleus pulposus. It is a considerably safe procedure with minimal complications when performed carefully.
3. For a central disc herniation surgical approach from both sides may preferably render a better result.
4. In cases when the nucleus pulposus being protruded way laterally a decompression of the nerve root is mandatory in the foraminal and the disc interspace.
5. The posterior approach for the thoracic disc herniation may render a considerable damage to the spinal cord with subsequent paraparesis. The anterolateral or posterolateral procedure may give a better result.
6. 97.7% of lumbar disc surgery disclosed from an improvement to recovery.
7. The anterior approach for the cervical intervertebral discs gives a better result; 98% of the surgeries disclosed an improvement to recovery.

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