Could isthmic approach to far lateral disc hernias cause instability?

Sarı, Ramazan; Elibol, Fatma Kübra Erbay; Özlü, Eylem Burcu Kahraman; Elmacı, İlhan; Demir, Teyfik

doi:10.1016/j.clinbiomech.2020.105004

Cited by 4 publications

(5 citation statements)

References 19 publications

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“…In a biomechanical study on sheep spine, Sarı et al compared the vertebrae in which they resected 50% and resected 25% lateral to the pars interarticularis [16]. The 50% resected group was found to be more susceptible to lateral bending [16]. With partial pars resection, the amount of bone resection does not exceed the lateral 1/4th width of the pars as demonstrated in one of our patient's postoperative CT scans (Figure 5).…”

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

“…Our study aims to describe the extraforaminal microdiscectomy for FLLDH by midline incision, using the Taylor retractor and routine lumbar disc herniation (LDH) tools. As with other surgical approaches for FLLDH, root damage, residual disc, cerebrospinal fluid leakage, and neuropathic leg pain due to manipulation of the dorsal root ganglion are possible complications [7,[15][16]. In the present study, the results of 18 patients were retrospectively evaluated, and the obtained experiences and the mid-term surgical outcomes of FLLDH were shared.…”

Section: Introductionmentioning

confidence: 98%

“…For FLLDH, several conventional techniques have been described in the literature as extending medial exposure to medial facetectomy, total facetectomy, and the trans-pars technique and extraforaminal exposure [11][12][13][14]. However, hemilaminectomy is performed as the lateral expansion of the classical median approach, and the partial or total laminectomies added to it cause radicular pain due to segmental instability and asymmetric disc collapse [15][16][17]. More recently, the preferred method is increasingly shifting toward the minimally invasive surgery (MIS) and modified paramedian approaches, which intend to protect the lamina and the facet has been commonly used [1,4].…”

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Far Lateral Lumbar Disc Herniation: Outcomes of the Safe and Simple Midline Approach

Kaya¹,

Keskin²,

Ceylan³

et al. 2022

Cureus

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Surgery for far lateral lumbar disc herniation (FLLDH) hernias is different than surgery for median and paramedian disc hernias. Our study offers a minimally invasive surgical technic for far lateral disc herniations. MethodsThe results of the midline surgical approach in 18 patients diagnosed with FLLDH were evaluated retrospectively. ResultsA total of 18 patients (7 females, 11 males), with a mean age of 57.9±9.4 years (range: 35-71 years), were included in the analyses. Three patients (16.7%) had lesions at the left L3-L4 level, six patients (33.3%) on the left L4-L5 level, five patients (27.8%) on the right L3-L4 level, and four patients (22.2%) on the right L4-L5 level. All patients had low back and leg pain. These complaints completely regressed after surgery. ConclusionThis study presents a review of a consecutive series of patients who underwent minimally invasive surgery for FLLDH using a midline approach.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Surgical Treatment of Far Lateral Lumbar Disc Herniation: Outcomes of the Safe and Simple Midline Approach

Kaya¹,

Keskin²,

Ceylan³

et al. 2022

Cureus

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“…Previous reports include a description of the partial removal of the lateral pars. The lateral pars actually has the largest thickness, and its removal has a potential for iatrogenic stress fractures [ 18 , 19 ]. Similarly, surgeons that target the facet joint risk worse outcomes in cases of excess removal of even 25% of the joint [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process

2022

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Background and Objectives: The use of minimally invasive retractor systems has significantly decreased the amount of tissue dissection and blood loss, and the duration of post-operative recovery after far-lateral disc herniations (FLDH). In this technical note, the technique of docking the tubular retractor on the caudal transverse process is described for an efficient approach with a decreased need for manipulation of the exiting nerve root. Materials and Methods: The case reported is that of a woman affected by a right-sided FLDH at the L4–5 level causing an L4 radiculopathy with weakness and numbness. A review of the literature for FLDH regarding the key anatomy used during a far lateral approach was also performed. Results: The patient showed a significant improvement of her dorsiflexion weakness and radiating leg pain at her 2-week and 5-week post-operative visits, and at a 6-month follow-up she had near-complete relief of her symptoms, including resolution of foot numbness. Prior techniques for tubular microdiscectomy for FLDH report docking on the facet joint, pars interarticularis, and the cranial transverse process. Conclusions: This technical note details that the utility of docking a tubular retractor at the caudal transverse process improves upon already established techniques for minimally invasive tubular discectomy for FLDH.

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Percutaneous Endoscopic Discectomy Via a Transforaminal Approach for L5/S1 Far-Lateral Disc Herniation Assisted by Intraoperative Computed Tomography

et al. 2022

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Could isthmic approach to far lateral disc hernias cause instability?

Cited by 4 publications

References 19 publications

Surgical Treatment of Far Lateral Lumbar Disc Herniation: Outcomes of the Safe and Simple Midline Approach

Surgical Treatment of Far Lateral Lumbar Disc Herniation: Outcomes of the Safe and Simple Midline Approach

A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process

Percutaneous Endoscopic Discectomy Via a Transforaminal Approach for L5/S1 Far-Lateral Disc Herniation Assisted by Intraoperative Computed Tomography

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