Türk Nöroşirürji Dergisi 2014 , Vol 24 , Num 3
The Facilitated Intertransverse Approach for Far Lateral Lumbar Disc Herniation
Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Nöroşirürji Kliniği, Ankara, Türkiye AIM: The median paramuscular intertransverse approach for far lateral lumbar disc herniation requires a fairly large skin and fascia incision. The purpose of this study was to demonstrate that the intertransverse approach in far lateral disc herniation can also be used with a convex skin and fascia incision.

MATERIAL and METHODS: Six cases of far lateral lumbar disc herniation were admitted to our clinic. Four patients were treated with a convex skin and fascia incision, and paramuscular intertransverse microdiscectomy. Severe pain and varying degrees of neurological deficits were found in far lateral lumbar disc herniation at admission to hospital.

RESULTS: Postoperatively, one patient complained of burning radicular pain continuing in the other hand while there was improvement in the pain and motor deficit findings in four patients. There was no wound healing problem or radiological iatrogenic instability development.

CONCLUSION: It is possible to access the intertransverse space with a median convex skin-fascial incision and median paramuscular muscle dissection. This approach enables a smaller incision and decreased soft tissue resistance. The approach should be preferred when possible. Anahtar Kelimeler : Intertransverse approach, Convex incision, Microdiscectomy, Far lateral disc herniation