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Related Experiment Video

Updated: Sep 6, 2025

Full Endoscopic Interlaminar Approach for Paracentral L5-S1 Disc Herniation
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Case Series of Tubular Retractor Assisted Minimally Invasive Extraforaminal L5/S1 Microdiskectomy.

Joyce Antony1, Dianne Hong Ngoc Le2, Liqun Yang3

  • 1Department of Neurosurgery, Gold Coast University Hospital, Southport, Queensland, Australia; School of Medicine, The University of Queensland, St Lucia, Queensland, Australia.

World Neurosurgery
|June 28, 2022
PubMed
Summary

This study shows tubular assisted minimally invasive extraforaminal L5/S1 microdiskectomy is effective for L5 radiculopathy. The approach provides good outcomes, avoiding complications of open surgery.

Keywords:
DiskectomyExtraforaminalFar-lateralL5/S1Minimally invasiveTubular

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Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Minimally Invasive Surgery

Background:

  • Extraforaminal L5/S1 disc herniation presents surgical challenges due to anatomical limitations.
  • These challenges include limited access caused by the iliac crest, sacral ala, and L5 transverse process.

Purpose of the Study:

  • To present the largest series of tubular assisted minimally invasive extraforaminal L5/S1 microdiskectomy.
  • To describe operative nuances and evaluate outcomes of this technique.

Main Methods:

  • A case series of 28 consecutive patients undergoing tubular retractor-assisted minimally invasive extraforaminal L5/S1 microdiskectomy (2017-2020).
  • Preoperative variables included demographics, imaging characteristics (spondylolisthesis, instability), and patient-reported pain/function.
  • Postoperative outcomes (complications, pain, function) were assessed at 1-day, 3-month, and 12-month follow-ups.

Main Results:

  • The study included 28 patients (13 female, 15 male) with a median age of 62 years.
  • 93% of patients achieved complete pain resolution post-surgery.
  • One patient with spondylolisthesis had no dynamic instability; two patients had persistent/recurrent radicular pain, with one resolving after a repeat procedure. No other complications were reported.

Conclusions:

  • Tubular retractor-assisted minimally invasive extraforaminal L5/S1 microdiskectomy is an effective surgical approach.
  • This technique achieves good surgical outcomes while avoiding complications associated with open surgery or fusion.