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CRITERIA FOR SPINE FUSION FOLLOWING REMOVAL OF PROTRUDED NUCLEUS PULPOSUS
Guy A. Caldwell; William B. Sheppard
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Department of Orthopaedics, Ochsner Clinic, New Orleans
1948 by The American Orthopaedic Association, Inc.
The Journal of Bone & Joint Surgery.  1948; 30:971-980 
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Abstract

The results of this study in proved cases of protrusion of the nucleus, there to seven years after laminectomy without fusion, suggest the following answers to the questions propounded earlier in this discussion:

1. Excellent ans satisfactory results can be obtained in as high a petcentage of cases by laminectomy alone as by the combined operation.

2. Hypertrophic changes of variable degree, with or without narrowing of the disc, occurred in 69.3 per cent. of the cases studied.

3. Functional end results do not correlate with or depend upon the presence or extent of such postoperative changes.

4. The end results are not significantly related to the existence of anomalies.

5. Recurrences took place in 8 per cent. of the cases studied, but did not seem to relate to the presence of anomalies or postoperative narrowing of the disc and hypertrophic changes. The number of recurrences was small, and there was nothing in the preoperative history and findings which indicated that protrusion would occur again at the same or another level.

Most of the unsatisfactory results (other than recurrence of protruded disc) were such that spine fusion would not have improved them.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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