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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
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Technical note: microdiscectomy and translaminar approach.

Daniele Vanni1, Renato Galzio2, Anna Kazakova3

  • 1Orthopaedic and Traumatology Department, G. D'Annunzio University, Chieti, Italy ;

Journal of Spine Surgery (Hong Kong)
|September 30, 2016
PubMed
Summary

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The translaminar approach offers a tissue-sparing technique for lumbar disk herniation (LDH) with fragment migration. This method provides symptom relief, reduces pain, and speeds recovery without causing instability.

Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Spinal Surgery

Background:

  • Lumbar disk herniation (LDH) is a common degenerative spinal condition.
  • Fragment migration occurs in approximately 10% of LDH cases, complicating standard surgical approaches.
  • Traditional interlaminar approaches may require extensive bone removal (laminotomies, facetectomies) in migrated LDH cases.

Purpose of the Study:

  • To evaluate the translaminar approach as a tissue-sparing alternative for treating lumbar disk herniation with fragment migration.
  • To highlight the safety, efficacy, and advantages of the translaminar technique compared to standard methods.
  • To detail the surgical technique, including tips and tricks for its application.

Main Methods:

  • The study focuses on the translaminar surgical technique for lumbar disk herniation.
Keywords:
Translaminar approachhidden zonelumbar disc hernia (LDH)microdiscectomyminimally invasive approach

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  • It analyzes the application of this approach in cases with cranially migrated fragments.
  • The technique's viability for specific spinal levels (above L2-L3 and below L3-L4) is discussed.

    • Main Results:

    • The translaminar approach is effective in resolving symptoms associated with migrated LDH.
    • It leads to reduced postoperative pain and faster recovery times.
    • This technique avoids the risk of iatrogenic instability and preserves the flavum ligament.

    Conclusions:

    • The translaminar approach is a safe and effective "tissue-sparing" technique for managing lumbar disk herniation with fragment migration.
    • It offers significant advantages over standard interlaminar methods, including less invasiveness and improved patient outcomes.
    • The technique is suitable even in cases with pre-existing radiographic instability.