Percutaneous removal of herniated lumbar discs. 50 cases with ten-year follow-up periods.

L4-L5 herniated discs documented by myelogram were removed percutaneously from 50 patients, under local anesthesia and X-ray control, and the patients were followed for ten years. Forty-three patients (86%) had relief of sciatica and sensory deficit. However, only one out of eight patients who had had motor neurological deficit had return of normal power and relief of sciatica from this procedure. The best clinical results were in those patients who felt improvement and relief of pain in the leg at the time of the removal of the disc material. The best clinical results were in patients with a major bulge of the disc and decompression of the nerve root. Patients with sequestration of the disc do not uniformly respond well to this procedure. There were no significant complications. Percutaneous excision of herniated L4-L5 lumbar discs, under local anesthesia, is a safe and valid procedure to reduce patient morbidity and hospital stay, and it does not prejudice the outcome of a formal laminectomy if it should fail.