The Surgical Treatment Of Far Lateral Lumbar Disc Herniation : 33 Cases / Erhan CELIKOGLU in Acta Orthopaedica Belgica, Vol 80/4 (Décembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.468-476 Titre : The Surgical Treatment Of Far Lateral Lumbar Disc Herniation : 33 Cases Type de document : texte imprimé Auteurs : Erhan CELIKOGLU, Auteur Année de publication : 2014 Article en page(s) : p.468-476 Langues : Anglais (eng) Mots-clés : extraforaminal  disc herniation  far lateral disc  intertraverse approach  transforaminal approach Résumé : Surgical approaches to far lateral disc herniation are challenging because of the anatomical limitations in the region. We describe an extraforaminal approach for far lateral lumbar disc herniation (FLLDH) in a group of patients and discuss the results in patients with far lateral disc protrusion or extrusion operated on by an approach to the extraforaminal region via an intertransverse route with median or paramedian incisions. The two methods are compared in terms of the pre- and postoperative visual analogue scale (VAS) pain scores, duration of the operation, amount of bleeding, and long-term functional recovery. In addition, data on age, incidence, radiological features and clinical signs and symptoms are compared with reported series. Between January 2006 and January 2011, 33 patients (18 females, 15 males ; mean age, 51.2 years) underwent surgery for FLLDH. The majority of patients had herniation at disc levels L3-4 (12 patients) or L4-5 (15 patients). All patients were operated on via either median-paramuscular (20 patients, 61%) or paramedian- intermuscular (13 patients, 39%) approaches. Overall, the mean VAS score improved from 7.3 preoperatively to 2.8 in the short-term. Analyzing the long-term functional outcome of surgery according to the MacNab Criteria, the recovery was excellent, good, fair, and poor in 18, 11, 4, and 0 patients, respectively. The far-lateral approach for FLLDH is a safe, effective procedure that avoids the risk of secondary spinal instability. In treating FLLDH, the use of a long median incision together with an extraforaminal approach is safer and less invasive than a laminectomy together with a medial or total facetectomy. Permalink : ./index.php?lvl=notice_display&id=34666 [article] The Surgical Treatment Of Far Lateral Lumbar Disc Herniation : 33 Cases [texte imprimé] / Erhan CELIKOGLU, Auteur . - 2014 . - p.468-476. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/4 (Décembre 2014) . - p.468-476 Mots-clés : extraforaminal  disc herniation  far lateral disc  intertraverse approach  transforaminal approach Résumé : Surgical approaches to far lateral disc herniation are challenging because of the anatomical limitations in the region. We describe an extraforaminal approach for far lateral lumbar disc herniation (FLLDH) in a group of patients and discuss the results in patients with far lateral disc protrusion or extrusion operated on by an approach to the extraforaminal region via an intertransverse route with median or paramedian incisions. The two methods are compared in terms of the pre- and postoperative visual analogue scale (VAS) pain scores, duration of the operation, amount of bleeding, and long-term functional recovery. In addition, data on age, incidence, radiological features and clinical signs and symptoms are compared with reported series. Between January 2006 and January 2011, 33 patients (18 females, 15 males ; mean age, 51.2 years) underwent surgery for FLLDH. The majority of patients had herniation at disc levels L3-4 (12 patients) or L4-5 (15 patients). All patients were operated on via either median-paramuscular (20 patients, 61%) or paramedian- intermuscular (13 patients, 39%) approaches. Overall, the mean VAS score improved from 7.3 preoperatively to 2.8 in the short-term. Analyzing the long-term functional outcome of surgery according to the MacNab Criteria, the recovery was excellent, good, fair, and poor in 18, 11, 4, and 0 patients, respectively. The far-lateral approach for FLLDH is a safe, effective procedure that avoids the risk of secondary spinal instability. In treating FLLDH, the use of a long median incision together with an extraforaminal approach is safer and less invasive than a laminectomy together with a medial or total facetectomy. Permalink : ./index.php?lvl=notice_display&id=34666

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