Ligament-sparing lumbar microdiscectomy: technical note.
BACKGROUND
The prevention or inhibition of postoperative adhesions is a significant goal for successful lumbar discectomy, not only to reduce the probable risk of recurrent radiculopathy, but also to improve the likelihood of success of re-operation.


METHODS
We describe a new technique for sparing the ligamentum flavum in lumbar microdiscectomy. The superficial layer of the ligament is removed by horizontal splitting. Additional horizontal splitting of the ligament yields a paper-thin deep layer. Lateral vertical splitting and retraction is then carried out to provide a sufficient operative window. The split ligament returns to its original position after releasing the retraction, thereby closing the operative window.


RESULTS
This method could preserve a layer of the ligamentum flavum to act as a physical barrier, which in turn greatly restricts the peridural fibrosis.


CONCLUSIONS
This ligament-sparing technique enables surgeons to preserve the original anatomic plane and to reduce the extent of postoperative adhesion.
Song
J
J
Department of Neurosurgery, College of Medicine, Medical Research Center, Ewha Womans University, Seoul, South Korea.
Park
Y
Y
D000328:Adult; D017586:Diskectomy / Q000379:methods*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery*; D008022:Ligaments; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*