Minimal Superior Articular Process Removal of Facet Joint in Lateral Interpedincular Approach Could Provide a Better Exposure in Far Lateral Disc Herniation Treatment: A Technical Report

Abstract

Objective: To assess the results of 28 patients who underwent lateral interpedicular surgical approach (LISA) and to compare the outcomes with the current literature. Materials and Methods: Twenty-eight patients with far lateral lumbar disc herniation (FLLDH) undergoing LISA between 2015 and 2018 were retrospectively analyzed. Extruded or sequestered far lateral lumbar disc herniations, which cause radiculopathy, were included in this study. A visual analogue scale (VAS) and patient's subjective comment on the result of surgery with Mac Nab Classification were recorded at the pre-and post-operative follow-ups. Results: There were 15 males and 13 females. The mean age was 50.5± 9.65 years. Two patients had L2-3 herniations, 11 had L3-4, and 15 had L4-5. The mean duration of operation was 48.8±8.7 minutes. Preoperative VAS scores (9.32±0.61) were found to decline to 0.78±0.57. The Mac Nab Classification of the postoperative 6 th month results yielded 78.5% to be excellent, 14.2% to be good and 7.1% to be fair. There were no complications, including CSF leak, nerve injury or hematomas. Conclusion: The LISA is a minimally invasive, safe and simple procedure for FLLDH surgery with short hospital stay and duration of operation and with low complication rates.