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Translaminar microendoscopic herniotomy for cranially migrated lumbar disc herniations encroaching on the exiting
Ko Ikuta1, Osamu Tono, Hideyuki Senba
1Department of Orthopedic Surgery, Karatsu Red Cross Hospital, Karatsu, Japan.
Study Design:
Case series.
Purpose:
The aim of this study was to describe translaminar microendoscopic herniotomy (TL-MEH) for cranially migrated lumbar disc herniations encroaching on the exiting nerve root in the preforaminal and foraminal zones and to report preliminary results of the procedure.
Overview Of Literature:
Conventional interlaminar approaches for preforaminal and foraminal lumbar disc herniations result in extensive removal of the lamina and facet joint to remove disc fragments safely. More destructive approaches increase the risk of postoperative segmental instability.
Methods:
TL-MEH is a minimally invasive procedure for herniotomy via the translaminar approach using a microendoscopic technique. TL-MEH was performed in seven patients with a cranially migrated lumbar disc herniation encroaching on the exiting nerve root. The disc fragments were located in the preforaminal zone in four patients, and in the preforaminal and foraminal zones in three.
Results:
All patients experienced immediate relief from symptoms after surgery and satisfactory results at the final follow-up. Surgical complications, such as a dural tear, nerve injury, and surgical site infection, were not investigated.
Conclusions:
TL-MEH seemed to be an effective and safe alternative minimally invasive surgical option for patients with a cranially migrated lumbar disc herniation encroaching the exiting nerve root in the preforaminal and foraminal zones.
Insights
Translaminar microendoscopic herniotomy (TL-MEH) offers an effective, minimally invasive surgical option for cranially migrated lumbar disc herniations. This technique provided immediate symptom relief and satisfactory outcomes in preliminary patient results.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
- Spinal Anatomy
Background:
- Conventional lumbar disc herniation surgery risks instability due to extensive bone removal.
- Preforaminal and foraminal disc herniations pose surgical challenges.
Purpose of the Study:
- Describe translaminar microendoscopic herniotomy (TL-MEH) for specific lumbar disc herniations.
- Report preliminary outcomes of TL-MEH for cranially migrated disc fragments.
Main Methods:
- TL-MEH is a minimally invasive technique using a translaminar approach and microendoscopy.
- Procedure performed on seven patients with cranially migrated lumbar disc herniations.
- Disc fragments located in preforaminal and/or foraminal zones.
Main Results:
- All patients achieved immediate symptom relief post-surgery.
- Satisfactory outcomes were reported at final follow-up.
- Complications like dural tear or nerve injury were not assessed.
Conclusions:
- TL-MEH appears to be a safe and effective minimally invasive surgical alternative.
- Suitable for treating cranially migrated lumbar disc herniations in challenging locations.
