Microdiscectomy With Preservation of Ligamentum Flavum

Abstract

Objective. To analyze the results of microdiscectomy with preservation of the ligamentum flavum. Material and Methods. One hundred and fifty two patients underwent microdiscectomy with preservation of the ligamentum flavum. The ligamentum flavum was exposed and cut in an apron-like shape, after disk hernia total removal an «apron» of the ligamentum flavum was placed in the interarticular space. Results. Radicular pain syndrome was completely arrested in 73.7 % of patients, significant decrease in radicular pain was observed in 22.4 %, and 3.9 % of patients had no any dynamics of radicular pain syndrome. A complete regression of motor and sensitive disturbances was observed in 31.6 % of patients, incomplete recovery – in 53.3 %, and absence of any neurological dynamics – in 15.1 %. Most of patients (76.1 %) returned to their work in 3 months. Conclusion. Microdiscectomy with preservation of the ligamentum flavum is a new perspective method, which helps to minimize a surgical trauma and to improve outcomes in patients with hernia of a lumbar intervertebral disc. Preservation of the ligamentum flavum together with other epidural anatomic structures, such as epidural fat tissue and venous plexuses, is important for preventing epidural fibrosis that may cause a failed back surgery syndrome.