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Far lateral lumbar disc herniations
1Department of Neurosurgery, University of Utah School of Medicine, Salt Lake City.
Neurosurgery Clinics of North America
|January 1, 1993
Summary
Far lateral lumbar disc herniations with upwardly migrating fragments are common and require surgical expertise. A posterior microsurgical approach offers an effective solution for spine surgeons.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spine Surgery
Background:
- Far lateral lumbar disc herniations with cephalad fragment migration are increasingly recognized.
- Advanced imaging techniques facilitate the common detection of these herniations.
- Familiarity with foraminal and extraforaminal anatomy is crucial for spine surgeons.
Purpose of the Study:
- To highlight the increasing prevalence of far lateral lumbar disc herniations.
- To emphasize the importance of surgeon recognition and surgical proficiency in this region.
- To present a preferred surgical technique for addressing these herniations.
Main Methods:
- Review of anatomical descriptions of the foraminal and extraforaminal regions.
- Discussion of surgical techniques for far lateral disc herniations.
- Preference for a specific posterior, direct microsurgical approach.
Main Results:
- Far lateral lumbar disc herniations with cephalad migration are not rare.
- Contemporary imaging commonly reveals these herniations.
- The posterior, direct microsurgical approach is presented as effective.
Conclusions:
- Spine surgeons must be familiar with the anatomy and recognition of far lateral disc herniations.
- Surgical adeptness in the far lateral region is essential.
- A posterior, direct microsurgical approach via midline incision with foraminotomy is recommended for its ease, exposure, adaptability, and efficacy.