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The Microsurgical Translaminar Approach: A Technical Note
Asen H Cekov1, Donika I Vezirska1
1Department of Neurosurgery, Acibadem City Clinic University Hospital Tokuda, Sofia, BGR.
Cureus
|March 19, 2024
Summary
A novel microsurgical translaminar approach for large lumbar disc herniation (LDH) spares spinal structures. This technique avoids bone removal, potentially preventing instability and the need for fusion surgery.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Surgery
Background:
- Lumbar disc herniation (LDH) frequently causes low back pain and radiculopathy.
- Traditional interlaminotomy for LDH involves significant bone removal (facetectomy) and soft tissue disruption.
- Extensive bone removal can lead to spinal instability, potentially requiring lumbar fusion.
Purpose of the Study:
- To provide a detailed overview of a novel microsurgical translaminar approach for treating large LDH.
- To highlight a technique that preserves key spinal structures.
- To present an alternative to traditional decompression methods for LDH.
Main Methods:
- Detailed description of the microsurgical translaminar technique.
- Focus on sparing the facet joint, ligamentum flavum, and epidural soft tissues.
- Application in cases of large lumbar disc herniation.
Main Results:
- The microsurgical translaminar approach offers a method for large LDH decompression.
- Preservation of the facet joint, ligamentum flavum, and epidural tissues is emphasized.
- Potential to mitigate risks associated with extensive bone removal in traditional methods.
Conclusions:
- The microsurgical translaminar approach is a viable technique for large LDH.
- This method may reduce the incidence of spinal instability and the need for fusion.
- Further evaluation of this minimally invasive technique is warranted.

