The Microsurgical Translaminar Approach: A Technical Note

Lumbar disc herniation (LDH) is a very common cause of low back pain and unilateral radiculopathy. This pathology is traditionally approached via interlaminotomy with variable amounts of bony extensions, such as partial or total facetectomy and disturbance of soft tissue structures. However, the extensive bone removal may be the cause of spinal instability, thus necessitating lumbar fusion procedures in the longer-term perspective. A novel surgical technique that spares the facet joint, the ligamentum flavum, and the epidural soft tissues was previously proposed. We present a detailed overview of the microsurgical translaminar approach for large LDH.