Interlaminar approach for excision of lateral lumbar disc herniation: technical note.
METHODS
Technical note.


OBJECTIVE
To show that approaching the lateral lumbar disc from the contralateral interlaminar space offers a wider exposure with reduced facet removal.


BACKGROUND
The interlaminar approach is a well-established approach for the removal of lateral lumbar disc herniation (LLDH). However, access to the lateral disc space via this approach may be difficult and requires generous facet joint removal.


METHODS
A 41-year-old woman presented with a 2-year history of low back pain and severe left leg pain. Computerized tomography of the lumbar spine revealed a left-sided intraforaminal lateral disc protrusion at L4/5 level.


RESULTS
The patient underwent a left L4/5 discectomy and removal of the lateral disc via the interlaminar approach from the contralateral (right) side with excellent postoperative result.


CONCLUSIONS
The authors present a modification of the interlaminar microsurgical approach for excision of an intraforaminal lateral disc herniation in which the herniated disc is approached from the contralateral interlaminar space through a midline incision. The facet joint removal is less, and the exposure is superior to the traditional interlaminar approach.
Department of Neurosurgery, Leeds General Infirmary, Leeds, United Kingdom. debasishpal@yahoo.co.uk
Debasish
D
Pal
Atul Kumar
AK
Tyagi
D000328:Adult; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome