Türk Nöroşirürji Dergisi 2009 , Vol 19 , Num 3
Microsurgery with Tubular Retractor for Lumbar Discectomy and Laminectomy
Aykan ULUS
Ondokuz Mayıs Üniversitesi, Nöroşirürji Anabilim Dalı, Samsun, Türkiye Microdiscectomy described by Yasargil and Caspar is accepted as golden standart for the surgical treatment of lomber disc herniation. Recent years minimaly invasive methods became more popular for discectomy as happens in all fields of surgery. The most important difference between classical microdiscectomy and microsurgery for lumbar discectomy and laminectomy with tubular retractor is retraction of paraspinal muscles. While the muscle was dissected subperiostally in classical microdiscectomy, tubular retractor was placed intramuscular in tubular discectomy. Paraspinal muscles injury is lesser in tubular discectomy, because intramuscular tubular retractor cause less pressure to the paraspinal muscles and insertions of muscle is not harmed. This means less postoperative pain , early mobilization, less hospital stay, cost effectiveness and early return to their daytime activity and job for patients. Beside these advantages, there is no difference for effectiveness between microdiscectomy with tubular retractor and classical microdiscectomy, according to the long term results. Anahtar Kelimeler : Microdiscectomy, Transmuscular discectomy, Tubular discectomy