Harumichi Senda

Pathomechanism of spontaneous regression of the herniated lumbar disc: histologic and immunohistochemical study.

To ascertain the pathomechanism of spontaneous regression of lumbar disc herniation, histological and immunohistochemical studies on 100 herniated discs were performed. Inflammatory findings such as cell infiltration, neovascularization, and granulation were observed in 16.9% of the protruded discs, 81.8% of the subligamentously extruded discs, 100% of the transligamentously extruded disks, and 80% of the sequestrated discs. The infiltrated cells were composed mainly of macrophages and a small number of T lymphocytes. Furthermore, the cell infiltration was more prominent in the nucleus pulposus (NP) than in the annulus fibrosus (AF). There was no correlation between the occurrence rate of inflammatory response and the length of the period from onset to operation. Based on these findings, it is considered that an extruded or sequestrated disc has a potential to be resorbed by phagocytes.

Luque Instrumentation after Posterior Decompression for Lumbar Degeneration of High Aged Patients

Eighteen cases of Luque instrumentation with spinous process wiring after posterior decompression for lumbar degeneration of high aged patients were discussed.The operative time and intraoperative bleeding of them were not so different from those of the cases without Luque instrumentation. The mean duration until ambulation was 10 days. The improvement rate of JOA score was 72%.Comfortable stabilization for decompressed segment was obtained. The decrease in total lumbar motion was about 10 degree, and it did not disturb the ADL so much.This method is easy, and has good application when high aged patients need early ambulation, and when the instability of multiple segments exists or will occur by decompression.