Türk Nöroşirürji Dergisi 2010 , Vol 20 , Num 3
Extraforaminal Approach to Far-Lateral Lumbar Disc Herniations
Kağan TUN, Berker CEMİL, Tuncer GÖKER, Oğuzhan EYLEN, Murat KORKMAZ, Erkan KAPTANOĞLU
S.B. Ankara Numune Eğitim ve Araştırma Hastanesi, 1. Beyin Cerrahi Kliniği, Ankara, Türkiye AIM: Surgical access to far-lateral lumbar disc herniations is challenging due to the unique anatomical constraints of the region. The purpose of this study was to describe the extraforaminal approach for far-lateral lumbar disc herniations and to evaluate the effectiveness of this method on a small group of patients.

MATERIAL and METHODS: Sixteen patients underwent surgery for far-lateral disc herniations. Average patient age was 56.4 years, 11 patients were female and 5 male. The level concerned most was L3-L4 disc (9 patients). An extraforaminal approach is described for this type of disc herniation. All of the patients reported excellent or good results according to Macnab outcome criteria with an average follow-up of 19.5 months (range 1–2.8 years).

RESULTS: Improvement was shown in all patients postoperatively. None of the patients experienced residual motor deficits, three had residual decreased sensation. There were no recurrences or spinal instability.

CONCLUSION: The extraforaminal approach is a rational technique. Its advantages are that the spine is not opened and spinal stability is maintained. It requires minimal soft-tissue and bone resection and the herniated disc is directly visualized. Furthermore, it contains minimal manipulation of the neuro-vascular structures. Nevertheless, it requires an adequate learning curve and good familiarity with regional anatomy. Anahtar Kelimeler : Discectomy, Extraforaminal approach, Far-lateral disc herniation, Lumbar vertebra