Microsurgical muscle-splitting approach for extracanalicular lumbar disc herniation: an analysis of 28 consecutive cases.
Extracanalicular lumbar disc herniation (ELDH) is a specific clinical entity with compression of the nerve root in its extraforaminal course. The classical midline interlaminar approach is often difficult because the facet joint obviates a direct view of the nerve, and a partial facetectomy is required. Consequently, the risk of instability or continued postoperative back pain is increased. The authors performed a microsurgical muscle-splitting approach in an attempt to obtain a direct view of the disc rupture without sacrificing the facet joint. Twenty-eight consecutive patients were operated upon with this surgical procedure. A retrospective study showed that 10 patients (35.7%) had an excellent, 13 (46.4%) a good, 4 (14.3%) a fair and one (3.6%) a poor result, according to the Macnab criteria. No serious postoperative complications were noted. This procedure is safe, effective and less invasive.
Birbilis
Theodossios
T
Department of Neurosurgery, University Hospital of Alexandroupolis, Democritus University of Thrace Medical School, GR-68100, Dragana Alexandroupolis, Greece. theobirbilis@yahoo.com
Koulalis
Dimitrios
D
Matis
Georgios
G
Theodoropoulou
Efthymia
E
Papaparaskeva
Kleo
K
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000601:surgery