Extraforaminal lumbar herniation: "far lateral" microinvasive approach retrospective study.

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Spinal Anatomy

Background:

• Lumbar extraforaminal herniation involves a herniated disc fragment compressing a nerve root after exiting the spinal foramen.
• This compression occurs against the intertransverse ligament, impacting the spinal ganglion.
• The reported incidence of this condition ranges from 1% to 12%.

Purpose of the Study:

• To define lumbar extraforaminal herniation based on the herniated fragment's anatomic site.
• To evaluate the efficacy of a far lateral microsurgical approach for treating pure extraforaminal herniation.
• To advocate for surgical techniques that preserve spinal stability and minimize tissue disruption.

Main Methods:

• A retrospective analysis of 46 patients with pure extraforaminal herniation treated over 4 years.
• Utilized a far lateral microsurgical approach.
• Focused on avoiding bone resection and minimizing muscular retraction and vascular compromise.

Main Results:

• The study treated 46 patients with pure extraforaminal herniation using the far lateral microsurgical approach.
• This approach successfully addressed the herniation while avoiding bone resection.
• Muscular retraction and blood vessel closure were minimized during the procedures.

Conclusions:

• The far lateral microsurgical approach is a viable and effective treatment for pure extraforaminal herniation.
• This technique prioritizes the preservation of osseous, articular, and muscular structures.
• Advocates for minimally invasive surgical strategies in treating spinal pathologies.