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Comparing surgical approaches to lumbar disc herniations
  1. Jean-Valery Coumans
  1. Correspondence to Dr Jean-Valery Coumans, Department of Neurosurgery, Massachusetts General Hospital, Wang Building, Suite 745, 15 Parkman St, Boston, MA 02114, USA; jcoumans{at}partners.org

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What is the long term impact of different surgical techniques?

Lumbar disc herniations are common. In cases where significant symptoms persist after attempted non-operative treatment, a discectomy is indicated. Do different surgical techniques affect the long-term outcome?

Surgical techniques have evolved since the early days of lumbar disc excision.1 Advances in optics and illumination have allowed surgeons to gain access to the disc fragment with smaller incisions, and laminectomy has given way to unilateral laminotomy. As the trend towards smaller incisions and less bone removal continues, it is helpful to consider whether any differences in outcome will emerge and whether conventional microdiscectomy can be made safer. In this vein, the study by Overdevest et al provides a much needed addition to the spinal literature.2 In this study, the authors report on the 5-year follow-up results of a trial comparing tubular discectomy to conventional discectomy.3 The present study …

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