2003 Volume 9 Issue 1 Pages 38-41
Main theme of this issue is which situation is suitable to fusion for lumbar disc hernia in the elderly patients. In the elderly patients mechanical stress to lumbar may be smaller, the mobility of intervertebral disc is decreased, decompression from dorsal and ventral areas may be sufficient for disc hernia in combined stenotic spinal canal, therefore decompressive surgery will be mainly indicated. Fusion surgery in the elderly patients as the 1st surgery for disc hernia may be, hernia mass in less-degenerated discs, social demand for lumbar discs, and disc hernia in upper lumbar discs, which will be treated ventrally or dorsally with wide fenestration. Fusion surgery as the 2nd surgery may be, failed back cases without re-extrusion of disc hernia after herniotomy.