Conservative and surgical aspects of disc lesion management. Follow-up review of 244 cases.

A follow-up study of 244 patients who were admitted to hospital with the diagnosis of discogenic disease between 1963 and 1970 was conducted to determine more precisely when conservative care should stop and a myelogram study followed by surgical decompression should be considered. The number of patients who had electromyography was separately tabulated and totaled (154). Of these, 87 (56.5 percent) had normal and 67 (43.5 percent) abnormal findings. It is significant that 29 of the total had positive myelograms and operation, yet 16 (59 percent) of the 29 had normal electromyograms. This raises a question about how much confidence to place in negative electromyographic findings when deciding for or against surgical operation. However, negative electromyograms are very helpful in reassuring patients who are emotional and resistant to resuming useful activities.