Skip to main content
SpringerLink
Log in

Evaluation of standard nucleotomy for lumbar disc herniation using the Love method: results of follow-up studies after more than 10 years

  • Original Article
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

A retrospective analysis of long-term follow-up results more than 10 years after a standard nucleotomy for lumbar disc herniation with the Love method was done to determine the effectiveness of this procedure. Nucleotomy according to Love was the standard treatment for lumbar disc herniation before the various minimally invasive alternatives were recently introduced. Without long-term follow-up analysis of Love operations, evidence-based evaluation of those new methods is impossible. We believe that the standard nucleotomy procedure should now be evaluated precisely. In this study we present a comparison of 1-year follow-up results to the results more than 10 years after lumbar nucleotomy. Seventy-six consecutive patients who had undergone lumbar nucleotomy were identified. It was possible to assess 54 (71.1%) of the cases more than 10 years after surgery. The initial and final outcomes were assessed using the MacNab classification and the Japanese Orthopaedic Association (JOA) score. With the MacNab classification a successful outcome 1 year after surgery was achieved in 87.0% of the cases. At the final follow-up, this result was reduced to 74.1%. Seven patients required a second operation and patients under 21 years of age were at risk for reoperation. Patient overall satisfaction with the results of the standard nucleotomy was high. The disc height of the operation site significantly decreased after surgery; nevertheless, this did not affect the clinical outcome. A standard lumbar nucleotomy according to Love is a safe and reliable method of treating selected patients with lumbar disc herniations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bostman OM (1993) Body mass index and height in patients requiring surgery for lumbar intervertebral disc herniation. Spine 18:851–854

    CAS  PubMed  Google Scholar 

  2. Botsford JA (1995) The role of radiology in percutaneous laser disc decompression. J Clin Laser Med Surg 13:173–186

    CAS  PubMed  Google Scholar 

  3. Davis RA (1994) A long-term outcome analysis of 984 surgically treated herniated lumbar discs. J Neurosurg 80:415–421

    CAS  PubMed  Google Scholar 

  4. Dvorak J, Valach L, Fuhrimann P, Heim E (1988) The outcome of surgery for lumbar disc herniation. II. A 4–17 years’ follow-up with emphasis on psychosocial aspect. Spine 13:1423–1427

    CAS  PubMed  Google Scholar 

  5. Ebeling U, Kalbarcyk H, Reulen HJ (1989) Microsurgical reoperation following lumbar disc surgery. Timing, surgical findings, and outcome in 92 patients. J Neurosurg 70:397–404

    CAS  PubMed  Google Scholar 

  6. Epstein NE (1999) Laser-assisted diskectomy performed by an internist resulting in cauda equina syndrome. J Spinal Disord 12:77-79

    CAS  PubMed  Google Scholar 

  7. Findlay GF, Hall BI, Musa BS, Oliveira MD, Fear SC (1998) A 10-year follow-up of the outcome of lumbar microdiscectomy. Spine 23:1168–1171

    Article  CAS  PubMed  Google Scholar 

  8. Heliovaara M (1987) Body height, obesity, and risk of herniated lumbar intervertebral disc. Spine 12:469–472

    CAS  PubMed  Google Scholar 

  9. Herron LD, Turner J (1985) Patient selection for lumbar laminectomy and discectomy with a revised objective rating system. Clin Orthop 199:145–152

    PubMed  Google Scholar 

  10. Hirabayashi S, Kumano K, Ogawa Y, Aota Y, Maehiro S (1993) Microdiscectomy and second operation for lumbar disc herniation. Spine 18:2206–2211

    CAS  PubMed  Google Scholar 

  11. Ikeda T, Nakamura T, Kikuchi T, Umeda S, Senda H, Takagi K (1996) Pathomechanism of spontaneous regression of the herniated lumbar disc: histologic and immunohistochemical study. J Spinal Disord 9:136–140

    CAS  PubMed  Google Scholar 

  12. Japanese Orthopedic Association (1986) Criteria on the evaluation of the treatment of low back pain (in Japanese). J Jpn Orthop Assoc 60:391–394

    Google Scholar 

  13. Kambin P, O’Brien E, Zhou L, Schaffer JL (1998) Arthroscopic microdiscectomy and selective fragmentectomy. Clin Orthop 347:150–167

    PubMed  Google Scholar 

  14. Love JG (1959) Removal of protruded intervertebral discs with laminectomy. Proc Mayo Clin 14:800–805

    Google Scholar 

  15. MacNab I (1971) Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am 53:891–903

    Google Scholar 

  16. Padua R, Padua S, Romanini E, Padua L, de Santis E (1999) Ten- to 15-year outcome of surgery for lumbar disc herniation: radiographic instability and clinical findings. Eur Spine J 8:70–74

    CAS  PubMed  Google Scholar 

  17. Postacchini F, Lami R, Pugliese O (1988) Familial predisposition to discogenic low-back pain. An epidemiologic and immunogenetic study. Spine 13:1403–1406

    CAS  PubMed  Google Scholar 

  18. Regan JJ, Yuan H, McAfee PC (1999) Laparoscopic fusion of the lumbar spine: minimally invasive spine surgery. A prospective multicenter study evaluating open and laparoscopic lumbar fusion. Spine 24:402–411

    Article  CAS  PubMed  Google Scholar 

  19. Silvers HR (1988) Microsurgical versus standard lumbar discectomy. Neurosurgery 22:837–841

    CAS  PubMed  Google Scholar 

  20. Sortland O, Kleppe H, Aandahl M, Blikra G (1996) Percutaneous lumbar discectomy. Technique and clinical result. Acta Radiol 37:85–90

    CAS  PubMed  Google Scholar 

  21. Spengler DM, Freeman CW (1979) Patient selection for lumbar discectomy. An objective approach. Spine 4:129–134

    CAS  PubMed  Google Scholar 

  22. Sterm MB (1989) Early experience with percutaneous lateral disectomy. Clin Orthop 238:50–55

    PubMed  Google Scholar 

  23. Tibrewal SB, Pearcy MJ (1985) Lumbar intervertebral disc heights in normal subjects and patients with disc herniation. Spine 10:452–454

    CAS  PubMed  Google Scholar 

  24. Tonelli L, Falasca A, Argentieri C, Andreoli M, Merli GA (1983) Influence of psychic distress on short-term outcome of lumbar disc surgery. J Neurosurg Sci 27:237–240

    CAS  PubMed  Google Scholar 

  25. Tullberg T, Isacson J, Weidenhielm L (1993) Does microscopic removal of lumbar disc herniation lead to better results than the standard procedure? Results of a one-year randomized study. Spine 18:24–27

    CAS  PubMed  Google Scholar 

  26. Varlotta GP, Brown MD, Kelsey JL, Golden AL (1991) Familial predisposition for herniation of a lumbar disc in patients who are less than twenty-one years old. J Bone Joint Surg Am 73:124–128

    CAS  PubMed  Google Scholar 

  27. Weber H (1994) The natural history of disc herniation and the influence of intervention. Spine 19:2234–2238

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Shiga University of Medical Science, Shiga 520-2192, Japan

    Yasuo Saruhashi, Kanji Mori, Akitomo Katsuura, Shinobu Takahashi & Yoshitaka Matsusue

  2. Tane-daini Hospital, Osaka, Japan

    Sinsuke Hukuda

Authors
  1. Yasuo Saruhashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kanji Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Akitomo Katsuura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shinobu Takahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yoshitaka Matsusue
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sinsuke Hukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasuo Saruhashi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Saruhashi, Y., Mori, K., Katsuura, A. et al. Evaluation of standard nucleotomy for lumbar disc herniation using the Love method: results of follow-up studies after more than 10 years. Eur Spine J 13, 626–630 (2004). https://doi.org/10.1007/s00586-004-0690-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-004-0690-8

Keywords

Search

Navigation