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Combined approach for far-lateral lumbar disc herniation
Mehmet Faik Ozveren1, Turgay Bilge, Seref Barut
1Department of Neurosurgery, School of Medicine, Firat University, Elazig, Turkey. fozveren@firat.edu.tr
Neurologia Medico-Chirurgica
|April 21, 2004
Summary
This study combined interlaminar and intertransverse approaches for far-lateral lumbar disc herniation. The minimally invasive technique resulted in excellent neurological outcomes for all 18 patients.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Far-lateral lumbar disc herniation presents significant surgical challenges.
- Traditional approaches may offer limited exposure for complete disc evacuation and bone resection.
Observation:
- A combined midline approach utilizing interlaminar and intertransverse routes was employed for 18 patients with far-lateral lumbar disc herniation.
- Patients exhibited symptoms including acute severe sciatica, antalgic posture, positive neurological signs (Lasègue, femoral stretch tests), and deficits in motor, sensory, and reflex functions.
Findings:
- Discectomy via the combined approach led to excellent neurological outcomes in all patients.
- The follow-up period ranged from 5 to 8 years, demonstrating sustained positive results.
- This technique facilitated complete evacuation of the herniated disc and allowed for necessary bone resection procedures.
Implications:
- The combined midline approach is a safe and effective surgical option for treating far-lateral lumbar disc herniations.
- This technique offers advantages in achieving complete disc removal and addressing associated bony pathologies.
- Advocacy for this combined approach in managing complex far-lateral lumbar disc herniation cases is supported by the study's findings.