discectomy puts to use the modern technology of arthroscopic and endoscopic techniques to perform disc excisions. This surgery has produced great results in success rates as well as recovery time. A microdiscectomy requires only about a two and a half inch incision posterior to the disc, and only needs minimal shaving of the lamina to reach the affected foraminal space. The surgeon inserts a microscpope into the area, which projects the image onto a screen. He can then operate with much greater precision. A patient of a microdiscectomy needs usually about on or maybe two nights of hospitalization, and is encouraged to return to non stressful normal activities as soon as possible, usually about two weeks(Flagg, 1997).While a microdiscectomy partially removes the protruding disc, it leaves the rest of the disc intact. In a case where the entire disc must be removed, surgeons opt for a surgery called a fusion. This operation consists of the removal of the disc, and the use of pedicle screws to keep the spine in place, with the goal to have the vertebrae fuse together. This surgery is more involved than a microdiscectomy, and is open to more variation. The discussion continues on the degree of angle at which the screws should be inserted as well as the degree of lordosis and kyphosis at which the spine should be fixated. Research has shown to be contradictory as one study shows that the procedure should be done in kyphosis, or a slight rounding of the back, to prevent foraminal stenosis or narrowing(White et Al, 1999). A second study shows that fusion done in lordosis, or a slight arch in the lumbar region, would prevent flat back problems(Casey et Al, 1999). Despite these claims, still others contend that there is no evidence to support either fusion in kyphosis or lordosis and that there is no overwhelming advantage to either one(Molz, 1999).The cutting edge of fusion procedures includes the use of inter body fusion cages to ...
