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Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
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Contralateral discectomy as a novel approach for disc herniation compressing a conjoined nerve root: illustrative
Leonidas Trakolis1, Athanasios K Petridis1,2
1Department of Neurosurgery, St. Luke Hospital, Thessaloniki, Greece.
Journal of Neurosurgery. Case Lessons
|August 26, 2024
Summary
A rare conjoined nerve root complicated a lumbar disc herniation surgery. A novel contralateral approach was successfully used to treat the patient, offering a new surgical option for this challenging condition.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Anatomy
Background:
- Conjoined nerve root is a rare anatomical variant that can complicate spinal surgery.
- Diagnosis can be challenging, especially when coexisting with pathologies like disc herniation.
- Standard discectomy techniques may lead to irreversible nerve injury in these cases.
Purpose of the Study:
- To report a case of lumbar disc herniation with an incidental conjoined nerve root.
- To describe a novel surgical approach for managing disc herniation in the presence of a conjoined nerve root.
- To highlight the efficacy of the contralateral approach in such complex scenarios.
Main Methods:
- Case report of a 53-year-old female with L5-S1 left-sided disc herniation and radicular pain.
- Intraoperative identification of a conjoined nerve root.
- Application of a novel surgical technique (contralateral approach).
Main Results:
- The novel contralateral approach yielded very good surgical results.
- Successful removal of the disc herniation was achieved.
- Avoidance of nerve root injury was confirmed.
Conclusions:
- The contralateral approach can be a viable and effective option for disc herniation removal when a conjoined nerve root is present.
- This technique may be the only feasible method in select cases.
- Highlights the importance of intraoperative awareness and adaptability in spinal surgery.
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