青少年腰椎间盘突出症的病因及治疗

目的 :探讨青少年腰椎间盘突出症的病因和治疗。方法 :12例青少年腰椎间盘突出症均手术治疗 ,开窗术 9例 ,扩大开窗 3例 ,分析其病因 ,临床表现及治疗方法。结果 :随访全部病例 ,平均随访时间 1 5年 ,优良率达 92 3 %。结论 :外伤和畸形是造成青少年腰椎间盘突出症的主要原因 ;X线检查不易诊断和定位 ,体征明显是其临床特征。治疗上在严格保守治疗无效的情况下 ,手术治疗也是重要的治疗方法。     

Far-lateral disc herniations: the results of conservative management

The far-lateral herniated lumbar disc has become increasingly recognized as a cause for low back pain and lumbar radiculopathy as well as for "failed back syndrome" in certain improperly diagnosed cases. Several authors have reported that the majority of patients show poor response to conservative measures. To better understand the natural history, we performed a retrospective review of all lumbar herniated discs during a 3-year period, collecting 16 patients with 17 far-lateral disc herniations. All displayed radicular pain in the distribution of the root exiting at the same level as the herniated disc, with or without associated back pain. Twelve of the 17 disc herniations responded to conservative measures and had complete resolution of their radicular pain at follow-up. Also, at long-term follow-up, essentially all patients had experienced satisfactory subjective resolution of their weakness or sensory complaints. Five patients required surgery because of intractable pain despite conservative measures. Although our series for far-lateral disc herniations is small, we found that conservative measures do afford a relatively high nonoperative success rate of approximately 71%. This is in contrast to earlier implied or stated opinions indicating a low rate of successful nonoperative management as low as 10% in one series.     

Treatment of lumbar disc herniation in the second decade of life

Lumbar disc herniation is rare in patients under the age of 20 years. In the department of orthopaedic surgery of the University Hospital of Frankfurt, 33 patients below the age of 20 with lumbar disc herniation were treated over a period of 10 years. Eighteen were managed conservatively and 15 surgically. The purpose of this study is to report on the long-term outcome of these patients and to compare the results of conservative and surgical treatment. We analysed information obtained from the medical records, and for the long-term follow-up we prepared a questionnaire. The questionnaire was composed of general questions about the patients' lifestyle and their ability to return to a normal life and activity after treatment, together with a request for them to score their pain level and remaining symptoms. We found that the longest duration of symptoms before diagnosis was 72 months, with a mean duration of 11.1 months. Low back pain and monoradicular sciatica were the main complaints, but findings of neurological deficits were rare. Lasegue's sign and tight hamstrings seemed to be strong diagnostic signs in this age group. On the day of discharge, 94% of patients reported excellent or good results. The outcomes after a mean follow-up period of 5.4 years were similar in both treatment groups. Almost all patients were able to attain a normal activity level and few reported restrictions on their daily life. Only 14% complained of permanent pain and 7% reported poor results regarding their activity capabilities. In conclusion, we believe that in all cases of lumbar disc herniation in the second decade of life, conservative treatment should be pursued as a mainstay of treatment. Only after a certain time, if conservative treatment is ineffective, should surgical treatment be considered.     

Adolescent lumbar disc herniation: a case report

Lumbar spine disc herniations in children are a relatively rare condition reported to occur in less than 3% of those presenting with low back pain. Unlike the adult, the etiology and clinical picture often provides few clues to making the diagnosis. Although conservative management is the treatment of choice, surgical intervention may be required in some cases. The role of spinal manipulation in these cases may be of limited value. A case report is presented that illustrates the difficulty in making the diagnosis and conservatively managing lumbar disc herniations in children.     

Adolescent lumbar disc herniation in a Tae Kwon Do martial artist: a case report

Lumbar disc herniations are rare in children. The etiology and clinical picture may be different in children than in adults. Conservative management is the treatment of choice. Tae Kwon Do is a Korean martial art which is notorious for its high fast kicks. Tae Kwon Do will be an official Olympic sport in the year 2000. Low back pain is occasionally reported by Tae Kwon Do athletes but there are no reported cases in the literature on disc herniation in a Tae Kwon Do athlete. A case report is presented to illustrate clinical presentation, diagnosis, radiological assessment and conservative management of lumbar disc herniation in children.     

Cervical epidural steroid injections for symptomatic disc herniations

OBJECTIVES: Cervical disc herniations are a common cause of radicular pain from nerve root impingement and may necessitate surgical decompression to alleviate symptoms. The use of cervical epidural injections has not been studied in detail. The objective of this retrospective study was to examine the efficacy of cervical epidural steroid injections for the treatment of symptomatic herniated cervical discs. METHODS: Patients with herniated cervical discs without myelopathy that had failed conservative management and were otherwise surgical candidates were offered a trial of cervical epidural injections. The results and benefits of the injections were examined as well as the incidence of proceeding to surgical intervention. RESULTS: Of the 70 treated patients, 44 (63%) had significant relief of their symptoms and did not wish to proceed with surgical treatment. Of the 26 patients who underwent surgical decompression, 92% had successful resolution of their symptoms. The nonsurgical and surgical groups were similar in terms of gender, preinjection symptoms, or number of injections. However, significant differences between the two groups were found with regard to age (P<0.05) and time from initial consultation to initial injection (P<0.05). With an average of 13-month follow-up, 45 (65.3%) patients reported a good/excellent result per Odom criteria. In addition, 53 (75%) would attempt cervical epidural steroid injections again in the future. No complications were noted in our series. CONCLUSIONS: Cervical epidural injections are a reasonable part of the nonoperative treatment of patients with symptomatic cervical disc herniations. The success rates appear to be very similar to prior studies of lumbar epidural injections for symptomatic lumbar disc herniations. It appears that a large percentage of the patients may obtain relief from radicular symptoms and avoid surgery for the follow-up period up to 1 year. In addition, patients older than 50 years and those who received the injections earlier, less than 100 days from diagnosis, seemed to have a more favorable outcome.     

青少年腰椎间盘突出症

目的：探讨青少年腰椎间盘突出症的病因和治疗。方法：１３例青少年腰椎间盘突出症均手术治疗,开窗术９例,半椎切除３例,全椎板切除术１例;并分析其病因,临床表现及治疗方法。结果;随访全部病例,平均随访时间４．２的,优良率达９２．３％。结论：外伤和畸形是造成青少年腰椎间盘突出症的主要原因;症状轻,体征明显是其临床特征     

Management of disc herniations with bi-radicular symptoms via combined lateral and interlaminar approach

Large lumbosacral disc herniations causing bi-radicular symptoms are very rare clinical entities and may present a surgical challenge. This study was undertaken to evaluate the effectiveness of the simply modified combined lateral and interlaminar approach for the treatment of these unique disc herniations. Between 2000 and 2005, 18 patients with bi-radicular symptoms secondary to large disc herniations of the lumbar spine underwent surgery. There were 13 men and five women, ranging in age between 25 and 64 years (mean 54.3 years). In this three-step operation, the osseous areas that are not essential for the facet joint were removed and both upper and lower nerve roots were decompressed. There were no intraoperative or postoperative complications, except transient dysesthesia in one (5.5%) patient. The mean follow-up period was 62.6 months (range 36–96 months). At the latest follow-up examination, outcomes using the Macnab classification were excellent in 13 patients (72.2 %), good in four (22.2%) and fair in one (5.5%). Recurrent disc herniations and/or instability, either symptomatic or radiographic, have not occurred as a result of the procedure during the follow-up period. The combined approach described here is a safe and effective procedure in the surgical treatment of this subtype of disc herniations with bi-radicular involvement. It permits optimum decompression of both nerve roots, avoiding the risk of secondary spinal instability.     

Isolated C3–C4 disc herniations present as a painless myelopathy

BACKGROUND CONTEXT: Cervical disc herniations at the C3-C4 level are distinctly uncommon. The authors present the first case series of isolated C3-C4 disc herniations presenting with myelopathy. PURPOSE: To elucidate a rare presentation of the uncommon C3-C4 disc herniation. STUDY DESIGN: Case series. PATIENT SAMPLE: The four patients who presented with myelopathy caused by isolated C3-C4 disc herniations, at the spine unit, Vancouver General Hospital between 1999 and 2005. OUTCOME MEASURE: Improvement in neurological status. METHODS: We retrospectively reviewed the files of the patients. The clinical features and outcome of surgery were assessed. RESULTS: The C3-C4 disc herniation can present as with no or mild pain, and hand numbness was a prominent symptom. Early recognition and treatment led to favorable outcome. CONCLUSIONS: Myelopathy is rarely caused by a C3-C4 disc herniation. This etiology may be underdiagnosed but has a more favorable outcome in those cases where rapid diagnosis is followed by spinal cord decompression.     

Surgical and nonsurgical management of sciatica secondary to a lumbar disc herniation: five-year outcomes from the Maine Lumbar Spine Study.

STUDY DESIGN: A prospective cohort study. OBJECTIVE: To assess 5-year outcomes for patients with sciatica caused by a lumbar disc herniation treated surgically or nonsurgically. SUMMARY OF BACKGROUND DATA: There is limited knowledge about long-term treatment outcomes of sciatica caused by a lumbar disc herniation, particularly the relative benefits of surgical and conservative therapy in contemporary clinical practice. METHODS: Eligible, consenting patients recruited from the practices of orthopedic surgeons, neurosurgeons, and occupational medicine physicians throughout Maine had baseline interviews with mailed follow-up questionnaires at 3, 6, and 12 months and annually thereafter. Clinical data were obtained at baseline from a physician questionnaire. Outcomes included patient-reported symptoms of leg and back pain, functional status, satisfaction, and employment and compensation status. RESULTS: Of 507 patients initially enrolled, 5-year outcomes were available for 402 (79.3%) patients: 220 (80%) treated surgically and 182 (78.4%) treated nonsurgically. Surgically treated patients had worse baseline symptoms and functional status than those initially treated nonsurgically. By 5 years 19% of surgical patients had undergone at least one additional lumbar spine operation, and 16% of nonsurgical patients had opted for at least one lumbar spine operation. Overall, patients treated initially with surgery reported better outcomes. At the 5-year follow-up, 70% of patients initially treated surgically reported improvement in their predominant symptom (back or leg pain) versus 56% of those initially treated nonsurgically (P < 0.001). Similarly, a larger proportion of surgical patients reported satisfaction with their current status (63% vs. 46%, P < 0.001). These differences persisted after adjustment for other determinants of outcome. The relative advantage of surgery was greatest early in follow-up and narrowed over 5 years. There was no difference in the proportion of patients receiving disability compensation at the 5-year follow-up. The least symptomatic patients at baseline did well regardless of initial treatment, although function improved more in the surgical group. CONCLUSIONS: For patients with moderate or severe sciatica, surgical treatment was associated with greater improvement than nonsurgical treatment at 5 years. However, patients treated surgically were as likely to be receiving disability compensation, and the relative benefit of surgery decreased over time.     

When should conservative treatment for lumbar disc herniation be ceased and surgery considered?

Different authors recommend different time spans for conservative treatment before considering surgery in patients suffering from lumbar disc herniation. We analyzed the time of onset of symptoms such as pain, sensory deficit, and motor deficit in a surgically treated group in comparison to outcome after surgery in order to define a time threshold when surgical results deteriorate and operation should therefore be considered. General data, symptoms, signs, and neurological findings of 219 patients were preoperatively recorded. The outcome was evaluated according to the Prolo scale after a mean of 9.9 months. In the statistical workup, we calculated the duration of symptoms, sensory deficits, and motor deficit as continuous variables. Additionally, the population was divided into three groups of duration of symptoms, sensory deficit, or motor deficit for ≤30 days, 30–60 days, and >60 days. Statistically significant predictors for unfavourable outcome were, for example, a longer duration of preoperative pain and motor and sensory deficit. Patients suffering for more than 60 days from disc herniation were found to have statistically worse outcome than patients suffering for 60 days or less. Findings were similar for the different time groups concerning the duration of sensory deficit but not for duration of motor deficit. The overall outcome seems to be better when patients are operated on for lumbar disc herniations within 2 months after onset of symptoms and sensory deficits. Due to these findings, we recommend conservative treatment up to 2 months and, if conservative management does not succeed, consideration of surgery. Electronic Publication     

Mid- to long-term outcome of disc excision in adolescent disc herniation.

BACKGROUND CONTEXT: Adolescent disc herniation and its surgical treatment have been the subjects of many published clinical series. The majority of these series were heterogeneous; the number of adolescent patients (12-17 years) as opposed to young adults (18-20 years) was generally small and the length of follow-up varied greatly. Although the short-term outcome of disc excision in adolescents was mostly favorable, their long-term outcome is unknown. OBJECTIVES: To evaluate the mid- and long-term results of discectomy in patients younger than 17 years of age. STUDY DESIGN: Retrospective examination of a series of adolescent patients under the age of 17 years who underwent surgery for lumbar intervertebral disc herniation. PATIENT SAMPLE: The medical records of 26 patients (15 males, 11 females, 12-17 years old [average 14.6]) who were operated for lumbar intervertebral disc herniation in three spine centers between 1984 and 2002 were reviewed. These subjects represented the total number of patients meeting the criteria of adolescents undergoing discectomy for lumbar disc herniation in these institutions during the study period. All patients were located and contacted by an independent observer not involved in the care of these patients. Low back pain associated with leg pain was the main clinical symptom in 20 patients (77%), leg pain in 4 (15%), and back pain in 2 (8%). They all underwent posterior disc excision: 23 (88%) patients had one level discectomy, and 3 (12%) had simultaneous discectomy at two levels. The L4-L5 interspace was involved 19 times, and the L5-S1 interspace 10 times. Slipped vertebral apophysis was diagnosed in 4 patients (15%). Twelve of the 26 patients (46%) had a first-degree relative with a history of lumbar disc herniation. OUTCOME MEASURES: Telephone interviews provided follow-up data for 26 patients. Results were classified as excellent, good, moderate, or poor according to current symptom status, the need for additional surgery, the Oswestry Disability Index, and back and leg pain scores. RESULTS: The average time from surgery to follow-up was 8.9 years (range 3-21 years). At follow-up, the clinical results were excellent in 13 patients (50%), good in 4 (15%), moderate in 8 (31%), and poor in 1 (4%). Four subjects (15%) underwent a subsequent disc excision in the lumbar region, and one of them later underwent fusion. CONCLUSIONS: Discectomy provides satisfactory clinical results in young patients with disc herniation. The rate of reintervention (15%) is comparable to that in adults, indicating that discectomy for young patients should be approached similarly to that in adults.     

Chemonucleolysis versus surgery in lumbar disc herniations: correlation of the results to preoperative clinical pattern and size of the herniation

A prospective study was carried out on the results of chemonucleolysis or surgery in 156 patients who had lumbar disc herniations. All patients were considered as potentially good candidates for chemonucleolysis. Seventy-two received a chymopapain injection and 84 underwent surgery. Based on computerized tomography (CT) scan and/or myelography the herniations were distinguished as small, medium, and large. Also distinguished were three types of preoperative clinical patterns, Type A, Type B and Type C, corresponding to slight, moderate, and severe nerve root compression, respectively. Follow-up evaluations were made 1 month, 3 months, and an average of 2.8 years after treatment. The patients with a small disc herniation, who underwent chemonucleolysis, did slightly better as a group than those treated surgically. At 1 month, the proportions of satisfactory results were 75% in the chemonucleolysis group and 62% in the surgery series. At final follow-up, the proportions were 84% and 82%, respectively, but the ratio of excellent-to-good results was higher in the chemonucleolysis group. In the latter, most patients with satisfactory outcomes had a Type A or Type B clinical pattern. In medium-size herniations the results of surgery were slightly better than those of chemonucleolysis. At 1 month, 55% of patients in the chemonucleolysis group had satisfactory results compared with 74% of those in the surgery series; at final follow-up the proportions were, respectively, 76% and 86%. In the chemonucleolysis group most satisfactory outcomes were found in patients with a Type A or Type B clinical pattern. The results of chemonucleolysis in patients who had large herniations were significantly inferior to those of surgery: at final follow-up the results were satisfactory in 50% of patients in the chemonucleolysis group and 89% of those in the surgery series. Chemonucleolysis appears to be the treatment of choice in most patients with small disc herniations and an effective alternative to surgery in most patients with medium-size herniations when the preoperative clinical pattern indicates a slight or moderate nerve root compression. In all large herniations and in small- or medium-size herniations causing a severe nerve root impingement, surgery should be preferred to chemonucleolysis.     

Surgical treatment of thoracic disc herniations via tailored posterior approaches

We present clinical findings, radiological characteristics and surgical modalities of various posterior approaches to thoracic disc herniations and report the clinical results in 27 consecutive patients. Within an 8-year period 27 consecutive patients (17 female, 10 male) aged 30–83 years (mean 53 years.) were surgically treated for 28 symptomatic herniated thoracic discs in our department. Six of these lesions (21%) were calcified. In all cases surgery was performed via individually tailored posterior approaches. We evaluated the pre- and postoperative clinical status and the complication rate in a retrospective study. Nearly one half of the lesions (46.4%) were located at the three lowest thoracic segments. Clinical symptoms included back pain or radicular pain (77.8%), altered sensitivity (77.8%), weakness (40.7%), impaired gait (51.9%) or bladder dysfunction (22%). Costotransversectomy was performed in 8 patients, 1 lateral extracavitary approach, 2 foraminotomies, 15 transfacet and/or transpedicular approaches and 2 interlaminar approaches were used for removing the pathologies. After a mean follow-up of 38.6 months (3–100 months), complete normalization or reduction of local pain was recorded in 87% of the patients and of radicular pain in 70% of the cases, increased motor strength could be achieved in 55%, sensitivity improved in 76.2% and improvement of myelopathy was noted in 71.4%. Two patients suffered from postoperative impairment of sensory deficits, which in one case was discrete. The overall recovery rate within the modified JOA score was 39.5%. In 1 patient, two revisions were required because of instability and a persisting osteophyte, respectively. The rate of major complications was 7.1% (2/28). Surgical treatment of thoracic disc herniations via posterior approaches tailored to the individual patient produces satisfying results referring to clinical outcome. Posterior approaches remain a viable alternative for a large proportion of patients with symptomatic thoracic disc herniations.     

Relationships between outcomes of conservative treatment and magnetic resonance imaging findings in patients with mild cervical myelopathy caused by soft disc herniations.

STUDY DESIGN: A retrospective follow-up study of conservatively treated patients with mild cervical myelopathy caused by cervical soft disc herniation. OBJECTIVE: To investigate the outcome of conservative treatment for patients with mild myelopathy caused by cervical soft disc herniation and to evaluate usefulness of magnetic resonance findings in the prediction of the outcomes. SUMMARY OF BACKGROUND DATA: Recent studies on conservative treatment for cervical soft disc herniation have focused mainly on radiculopathy, and not on myelopathy. METHODS: Twenty-seven patients with mild cervical myelopathy secondary to cervical soft disc herniation were treated conservatively for more than 6 months by cervical bracing and restriction of daily activities. Of the 27 patients, 17 patients (Group A) underwent conservative treatment only and it was associated with improvement in their neurologic deficits, while the other 10 patients (Group B) ultimately underwent decompression surgery because of neurologic deterioration. Comparisons between the two groups were made in regard to JOA scores, patient satisfaction, and magnetic resonance findings, including location of the disc herniation (focal or diffuse in the sagittal plane, median or paramedian in the axial plane). RESULTS: The JOA scores were 13.6 +/- 1.6 in Group A and 14.1 +/- 1.6 in Group B before treatment, 14.9 +/- 1.0 and 12.9 +/- 2.1, respectively, at 3 months, and 16.2 +/- 0.8 and 16.0 +/- 1.2, respectively, at the final follow-up. The JOA scores at 3 months were significantly lower in Group B than in Group A. Satisfaction with the results of treatment at the final follow-up was reported by 77% of the patients in Group A and 90% in Group B. Focal-type herniation was present in 47% of the patients in Group A and 70% in Group B, while median-type herniation was diagnosed in 77% in Group A and 30% in Group B. Follow-up magnetic resonance imaging of the patients in Group A showed spontaneous regression of a herniated mass in 10 patients (59%). Diffuse-type herniations were more likely to regress spontaneously than focal-type herniations (78% vs. 37%). CONCLUSIONS: Conservative treatment is an effective treatment option for mild cervical myelopathy caused by cervical soft disc herniation. A good outcome can be expected in patients with a median-type and/or diffuse-type herniation on magnetic resonance imaging.     

Trends in adolescent lumbar disk herniation

The authors have retrospectively studied the trends in etiology, symptoms, and rate of recurrence for adolescents with disk herniations to determine the age at onset of symptoms, mechanism of injury, familial history, pattern of symptoms, level of herniation, method of treatment, and rate of recurrence. The review revealed a higher incidence of adolescent lumbar disk herniations in female patients and a higher percentage of patients with a family history than previously reported. Leg pain continues to be the primary presenting symptom in this group of patients and is often not recognized as the radicular pain of a herniated disk by the primary care physician. This reflects a lack of understanding of the relationship of the presenting symptoms to the pathology of the herniated nucleus pulposus, causing a delay in referral to the spine specialist.     

双节段人工椎间盘置换加融合在多节段颈椎间盘突出症的应用

目的 总结1例多节段颈椎间盘突出症患者相邻颈椎节段实施人工椎间盘置换和植骨融合的效果，以及二者间的相互影响，为多节段椎间盘突出症寻找新的外科治疗方法。方法2004年12月对确诊为C3～7椎间盘突出症的患者，实施C4～6椎间盘置换术，C3,4及C6、7椎间盘切除，椎体间行钛网植骨、Zephir钢板内固定术。术后2d下床行颈椎功能锻炼，术后3周～3个月颈椎支具制动。以术后动力位X线片衡量其颈椎活动范围。结果术后患者颈椎活动时无疼痛，脊髓神经症状有所缓解。获随访1年2个月，颈椎活动无明显受限，四肢感觉、肌力正常。动力位X线片可见颈椎前屈、后伸和左右侧弯活动范围均接近正常水平。结论人工椎间盘置换结合植骨融合治疗多节段颈椎间盘突出症，近期临床效果较好；术后早期加强颈椎功能锻炼，再限制颈椎活动，可较好地处理术后活动和制动的矛盾，达到手术目的。     

Lumbar disc excision in children and adolescents

STUDY DESIGN: The authors examined a case series of patients under the age of 18 years treated for lumbar intervertebral disc herniation. OBJECTIVES: To evaluate postoperative and long-term results of surgery in patients younger than 18 years. SUMMARY OF BACKGROUND DATA: There are only a few series, with controversial results, available on the surgical treatment of disc herniation in growing patients. METHODS: Between 1975 and 1991, a consecutive series of 129 patients 9-18 years of age (average age, 16.2 years) underwent surgery for lumbar intervertebral disc herniation. Low back pain associated with leg pain was the main clinical symptom in 106 subjects (82%), back pain in 17 (13%), and leg pain in 6 (5%). RESULTS: Short-term results were excellent or good for 123 cases (95%), with complete pain relief in 97 (75%) and moderate but incomplete relief in 26 (20%). A total of 98 (76%) long-term responses obtained at a mean follow-up of 12.4 years revealed excellent outcomes in 40% of the cases, good in 47%, and poor in 13%. Ten patients (10%) underwent reintervention after 9 years on average (2 fusions and 8 re-explorations for herniated disc). CONCLUSIONS: Results have confirmed a tendency for outcomes to deteriorate between the short-term and long-term follow-up in young patients treated by discectomy: this tendency and the rate of reintervention (10%) confirmed the need for long-term follow-up of children and adolescents treated for disc herniation.     

Far lateral thoracic disc herniation presenting with flank pain.

BACKGROUND CONTEXT: Although thoracic disc herniations are rare, misdiagnosis is an undesirable situation, as it results not only in unnecessary diagnostic studies and surgical procedures, but also in progressive myelopathy and paralysis. Therefore, it is important to be aware of patients with thoracic disc herniations presenting with unusual or atypical symptoms mimicking other non-spinal disorders. PURPOSE: A patient with left flank pain compatible with urinary system disorder, who proved to have thoracic disc herniation, is presented. STUDY DESIGN: Case report METHODS: The cause of the patient's pain could not be elucidated until thoracic spine magnetic resonance imaging revealed a left thoracic 10-11 lateral disc herniation with associated nerve root compression. RESULTS: Conservative therapy including bed rest and analgesic medication was initiated. He had complete pain relief within the same day. CONCLUSION: Thoracic disc herniation should be considered in the differential diagnosis of patients with pain likely caused by nonspinal disorders, especially if basic diagnostic studies do not reveal the cause.     

Acetabular labral tears: result of arthroscopic partial limbectomy.

SUMMARY: Acetabular labral tears are a rare but well recognized cause of hip symptoms in young adults. Both clinical and radiographic diagnoses are difficult. The treatment of choice in the past has been either conservative or open arthrotomy. Hip arthroscopy has proved to be an effective tool for both diagnostic and therapeutic purposes in patients with chronic hip pain refractory to conservative treatment. We reviewed a series of 76 arthroscopic limbectomies. All patients had experienced hip symptoms for more than 6 months. None responded to nonsurgical treatment. Results were evaluated with the Harris Hip Score and with a questionnaire. Fifty-eight cases had a mean 3.5 years follow-up (range, 24 to 61 months). Thirty-nine patients (67.3%) were pleased with the result of their operation. The remaining 19 (32.7%) were not satisfied. Arthroscopy is an effective noninvasive procedure for the assessment and treatment of labral lesions. Short-term follow-up shows encouraging results.