orthowhq compiled the following article in The Clove Orthopedic Hour, “Long-term outcomes of fusion and simple resection of herniated discs are similar” [after reading] Although the control group in this study was a fusion procedure without an arch nail, it reflects the clinical outcomes of treatment. As a minimally invasive spine surgeon, we have been adhering to the philosophy of step therapy and being able to treat small and not big. Lumbar disc herniation is a degenerative disease, the primary stage of human spinal degeneration, not the late or ultimate stage of human aging. Surgical interventions for degenerative diseases of the human spine should be implemented according to the following principles There is an old Chinese saying that one should not use a bull’s-eye to kill a chicken! This is what it says. China has been lifted out of poverty, even to a well-off life, but it is also true that we should not be extravagant and wasteful. There is a bragging joke: when we have money, we will go to drink soy milk and eat doughnuts. Shit! Want to dip white sugar in white sugar, want to dip brown sugar in brown sugar. Soybean milk buy two bowls at a time, drink a bowl, pour a bowl! This is not the reason for giving people surgery, “can not do it, can do small not big”. Why fuse it up when you can hollow it out alone? Fusion surgery should be reserved for spinal stenosis and slippage before it’s too late. Topic source: The long-term efficacy of fusion and simple resection for herniated discs is similar, and simple partial discectomy without fusion (interbody discectomy) is the standard treatment for radiating pain in the lower extremities of herniated discs at the time of clove orthopedics. However, because the intervertebral disc is a biomechanical stabilizer of the spinal motion unit, scholars consider post-discectomy segmental instability as a risk factor for residual low back pain and recurrence of disc herniation. Several fusion techniques are available, including PLIF, TLIF, and these new techniques fuse the primary herniated disc segment. In contrast, there are relatively few studies on the long-term follow-up efficacy of both unilateral discectomy and fusion. A retrospective long-term follow-up study conducted by scholars from the Department of Orthopaedics, Fukushima Medical University School of Medicine, Japan, clarified that the long-term efficacy of fusion of herniated discs is equivalent to unilateral discectomy, and the article was published in J Spinal Disord Tech in June 2014. The retrospective study cases included two groups: 39 cases of unilateral discectomy from hospital A, with a mean age of 41.9 years and a mean follow-up of 13.9 years; and 109 cases of discectomy + posterior posterolateral fusion without internal fixation (no internal fixation at that time) from hospital B, with a mean age of 44.3 years and a mean follow-up of 15 years. There were no statistical differences between the two groups of cases in terms of age, gender distribution, follow-up time and follow-up rate. The indicators assessed included subjective symptoms: analgesic use, duration of ambulation, modified quadratic efficacy criteria (excellent, good, moderate, poor), numerical pain scale, surgical satisfaction, and the Japanese version of the Roland-Morris Disability Index questionnaire. Objective symptoms included: straight leg raise test, manual muscle strength test, and sensory impairment. The results showed no statistically significant differences between the two groups in terms of subjective and objective indicators. There was also no statistically significant difference in the number of revision surgery cases between the two groups. These results suggest that discectomy + fusion is not superior to discectomy alone in terms of long-term outcomes. The long-term outcomes of discectomy alone and discectomy+fusion were comparable. Currently discectomy is the gold standard for surgical treatment of disc herniation where conservative treatment has failed, including traditional open decompression with nucleus pulposus removal; and minimally invasive discoscopic discectomy. While the long-term efficacy of conventional discectomy is proven, the long-term efficacy of discoscopic discectomy is unknown. Since the FDA approved the use of intervertebral fusion in 1996, fusion technology has developed rapidly. But can fusion change the long-term outcome of herniated discs? Although the fusion technique used in this study is outdated, it does provide us with good information. The average follow-up of 14 years strongly suggests that fusion does not improve the long-term outcome of patients with disc herniation. Although fusion prevents recurrence of disc herniation in that segment, there are not as many cases of revision due to adjacent segment degeneration brought on by fusion as there are cases of recurrence done alone.