Focus issue on lumbar disc herniation: macro- and microdiscectomy.

This paper is based on a review, analysis, and discussion of the extensive literature on indications, technique, and complications of discectomy (macro and micro) for lumbar disc herniation. Outcomes for lumbar discectomy for disc herniation depend on patient selection. Short-term results of discectomy are excellent when there is agreement between the clinical presentation and imaging studies. Long-term results of surgery are only slightly better than conservative measures and the natural history of a lumbar disc herniation. A review of the literature reveals success rates for lumbar discectomy ranging from 80-96%. The outcome of lumbar discectomy does not appear to be affected by the use of a microscope and depends more on patient selection than on surgical technique.