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January 1970

The Lumbar Intervertebral DiskA Clinicopathological Correlation Based on Over 100 Laminectomies

Author Affiliations

Chanute Air Force Base, Ill
From the Hospital for Joint Diseases and Medical Center, New York, and the Chanute Air Force Base Hospital, Ill. Dr. Gardner is now at 198 Union Ave, Framingham, Mass.

Arch Surg. 1970;100(1):101-104. doi:10.1001/archsurg.1970.01340190103024

The exact etiology and pathogenesis of intervertebral disk herniation remains unknown. However, man's erect posture and the process of aging are known to produce certain changes in disk structure. The semiliquid gel (nucleus pulposus) loses much of its highly elastic nature and becomes more fibrotic. Degeneration occurs by an increased deposition of collagen fibrils and there is a loss of nucleus water content and mucoid substance.1 The nucleus, as a three-dimensional lattice gel structure of a protein-polysaccharide complex, is prone to degeneration with aging.2

Microscopic evaluation of disks removed at surgery has not been able to correlate clinical symptoms and signs since they show only variable amounts of fibrocartilaginous tissue.3 It has been my personal observation in experiences with over 100 laminectomies in the lum bar region that simple gross examination of the lesional tissue offers a better correlation with the clinical findings.

Method  The usual clinical

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