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[Transsacral approach to lumbosacral extraforaminal disc herniations].
S Fuentes1, Ph Métellus, T Adetchessi
1Service de Neurochirurgie, CHRU de La Timone-Adulte, Marseille. sfuentes@ap-hm.fr
Neuro-Chirurgie
|March 24, 2006
Summary
The transsacral approach offers a safe alternative for treating L5-S1 extraforaminal disc herniations (EDH), effectively resolving radiculalgia and motor deficits without joint injury.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Orthopedic Surgery
Background:
- Extraforaminal disc herniations (EDH) at L5-S1 traditionally treated with lateral approach.
- Lateral approach may necessitate facet joint resection.
- Transsacral approach offers an alternative for L5-S1 EDH.
Purpose of the Study:
- To evaluate the efficacy and safety of the transsacral approach for L5-S1 EDH.
- To compare transsacral approach outcomes with traditional lateral approaches.
Main Methods:
- Retrospective study of 12 patients with L5-S1 EDH treated via transsacral approach (Feb 2002-Oct 2004).
- Patients presented with lumbalgia, L5 radiculalgia, and varying degrees of motor/sensory deficits.
- Surgical intervention followed failed conservative management and corticosteroid injections.
Main Results:
- All 12 patients achieved complete resolution of radiculalgia and paresthesia.
- Preoperative motor deficits fully recovered in all affected patients.
- Mean follow-up of 15 months, with all patients resuming normal activities.
Conclusions:
- Transsacral approach is a viable alternative for L5-S1 EDH treatment.
- This technique minimizes facet joint injury, preventing chronic postoperative pain.
- Avoids nerve root/ganglion mobilization, reducing risk of postoperative dysesthesia.