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.
Department of Neurosurgery, University Hospital of Alexandroupolis, Democritus University of Thrace Medical School, GR-68100, Dragana Alexandroupolis, Greece. theobirbilis@yahoo.com
Theodossios
T
Birbilis
Dimitrios
D
Koulalis
Georgios
G
Matis
Efthymia
E
Theodoropoulou
Kleo
K
Papaparaskeva
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