It is recognised that those patients who present sciatica and significant preceding back pain will be disappointed, following discectomy, with the relief of the sciatica alone, as considerable degenerate disc will remain.

Though a bilateral fenestration exposure as much disc possible was removed right down to the back of the anterior longitudinal ligament. Intervertebral fusion was not used.

Of 25 patients, with a mean follow up of 20 months, 59% reported a significant improvement in pain (p< 0. 05) and function (p< 0. 05) following surgery. Post-operative radiography did not reveal malalignment or instability.

Prolo D et al. Toward uniformity results of lumbar spine operation. A paradigm applied to posterior lumbar interbody fusions. Spine, 1986: 11:601–6.

Cauda equina syndrome (CES) due to central disc prolapse produces acute neurological deficit. We investigated long-term urological disability after surgery for CES and the impact of emergency versus next day surgery.

20 CES patients (M=F), were assessed using a validated quality of life questionnaire; comparison was made with a matched group undergoing simple lumbar disc surgery. Median length of history before presentation was seven days. Nine were operated on within 4. 5 hours, the remainder all within 24 hours after neurosurgical admission. While the patients’ perception was of good general health (no different from controls), urological symptoms adversely affected their lives (P=0. 02). Only two patients had no urological symptoms. Emergency surgery (within 4. 5 hours of presentation) was not associated with reduced disability.