Transforaminal microtubular discectomy for extraforaminal disc herniation using a 14-mm retractor

Area of Science:

• Neurosurgery
• Minimally Invasive Spine Surgery

Background:

• Extraforaminal (EF) disc herniations often require surgical intervention.
• Transforaminal (TF) approaches are popular, but the efficacy of TF microtubular discectomy with a 14-mm tubular retractor for EF herniations is less understood.

Purpose of the Study:

• To evaluate the safety and efficacy of minimally invasive transforaminal (TF) microtubular discectomy using a 14-mm tubular retractor for treating extraforaminal (EF) disc herniations.

Main Methods:

• Retrospective observational study of 20 patients with EF disc herniations who underwent TF microtubular discectomy with a 14-mm tubular retractor.
• Preoperative and postoperative Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were monitored.

Main Results:

• The 14-mm tubular retractor was successfully used in all patients, with low mean blood loss (29.85 mL) and operative time (30.50 minutes).
• Significant improvements were observed in leg VAS scores (7.6 to 2.0) and back VAS scores (1.23).
• Mean ODI scores improved from 57.20% to 12.60% at 1 year post-surgery, with one case of recurrent herniation.

Conclusions:

• TF microtubular discectomy using a 14-mm tubular retractor provides an adequate foraminal working channel for effective EF disc herniation decompression.
• The procedure leads to reduced pain, improved functional outcomes, and preservation of spinal integrity.