The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation
Background Data: Far lateral lumbar disc herniation accounts for 1-12% of all lumbar disc herniations. Every aspect of management of this unique type of lumbar disc herniation is challenging for spine surgeons, and no consensus has been reached for the best surgical approach and technique to use. P...
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Egyptian Spine Association
2017
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oai:doaj.org-article:8cdf05db3e2441ee8f96c63e2f0f73a42021-12-02T00:39:51ZThe Extraforaminal Approach for the Management of Far Lateral Lumbar Disc HerniationDOI:10.21608/ESJ.2017.56332314-89502314-8969https://doaj.org/article/8cdf05db3e2441ee8f96c63e2f0f73a42017-04-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_5633.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Far lateral lumbar disc herniation accounts for 1-12% of all lumbar disc herniations. Every aspect of management of this unique type of lumbar disc herniation is challenging for spine surgeons, and no consensus has been reached for the best surgical approach and technique to use. Purpose: The purpose of this study is to evaluate the extraforaminal approach, which is a less invasive approach, for the treatment of far lateral lumbar disc herniation. Study Design: A prospective case series. Patients and Methods: Of 501 lumbar disc prolapse patients treated surgically in our department between September 2013 and August 2015, 15 patients presented with far lateral lumbar disc herniation. These 15 patients (11 males and 4 females, mean age 46.80 ± 8.08 years) were treated surgically using the extraforaminal approach and were prospectively followed for 1 year. The study was approved by the Institution Ethical Committee, and all patients signed an informed consent form. Clinical and functional outcomes were assessed using VAS and ODI scores and MacNab’s criteria. Follow-up MRI was performed at 1 year. Results: Far lateral lumbar disc herniation accounted for 3% of all lumbar disc herniation patients treated surgically in our department. The mean back pain VAS score improved from 6.46 preoperatively to 1.06 at the 1-year follow-up evaluation (P=0.001). The mean leg pain VAS score improved from 7.40 preoperatively to 1.06 at the 1-year follow-up evaluation (P=0.001). The mean ODI score improved from 30.20 preoperatively to 2.80 at the 1-year follow-up evaluation (P=0.001). According to MacNab’s criteria, 12 patients (80%) had excellent outcomes, 3 (20%) had good outcomes, and no patients showed fair or poor outcomes at the final follow-up evaluation at 1 year. Conclusion: The extraforaminal approach seems to be a safe, less traumatic and less destabilizing approach for managing far lateral lumbar disc herniation and can lead to a better outcome than traditional approaches. (2017ESJ129)Al Moataz El-SabroutMohammad El-Sharkawi Mohamed El-Meshtawy Romany ZakiEgyptian Spine Associationarticlefar lateral lumbar discextraforaminal approachparamedian approachNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 22, Iss 1, Pp 15-22 (2017) |
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far lateral lumbar disc extraforaminal approach paramedian approach Neurology. Diseases of the nervous system RC346-429 |
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far lateral lumbar disc extraforaminal approach paramedian approach Neurology. Diseases of the nervous system RC346-429 Al Moataz El-Sabrout Mohammad El-Sharkawi Mohamed El-Meshtawy Romany Zaki The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
description |
Background Data: Far lateral lumbar disc herniation accounts for 1-12% of all lumbar disc herniations. Every aspect of management of this unique type of lumbar disc herniation is challenging for spine surgeons, and no consensus has been reached for the best surgical approach and technique to use.
Purpose: The purpose of this study is to evaluate the extraforaminal approach, which is a less invasive approach, for the treatment of far lateral lumbar disc herniation.
Study Design: A prospective case series.
Patients and Methods: Of 501 lumbar disc prolapse patients treated surgically in our department between September 2013 and August 2015, 15 patients presented with far lateral lumbar disc herniation. These 15 patients (11 males and 4 females, mean age 46.80 ± 8.08 years) were treated surgically using the extraforaminal approach and were prospectively followed for 1 year. The study was approved by the Institution Ethical Committee, and all patients signed an informed consent form. Clinical and functional outcomes were assessed using VAS and ODI scores and MacNab’s criteria. Follow-up MRI was performed at 1 year.
Results: Far lateral lumbar disc herniation accounted for 3% of all lumbar disc herniation patients treated surgically in our department. The mean back pain VAS score improved from 6.46 preoperatively to 1.06 at the 1-year follow-up evaluation (P=0.001). The mean leg pain VAS score improved from 7.40 preoperatively to 1.06 at the 1-year follow-up evaluation (P=0.001). The mean ODI score improved from 30.20 preoperatively to 2.80 at the 1-year follow-up evaluation (P=0.001). According to MacNab’s criteria, 12 patients (80%) had excellent outcomes, 3 (20%) had good outcomes, and no patients showed fair or poor outcomes at the final follow-up evaluation at 1 year.
Conclusion: The extraforaminal approach seems to be a safe, less traumatic and less destabilizing approach for managing far lateral lumbar disc herniation and can lead to a better outcome than traditional approaches. (2017ESJ129) |
format |
article |
author |
Al Moataz El-Sabrout Mohammad El-Sharkawi Mohamed El-Meshtawy Romany Zaki |
author_facet |
Al Moataz El-Sabrout Mohammad El-Sharkawi Mohamed El-Meshtawy Romany Zaki |
author_sort |
Al Moataz El-Sabrout |
title |
The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
title_short |
The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
title_full |
The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
title_fullStr |
The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
title_full_unstemmed |
The Extraforaminal Approach for the Management of Far Lateral Lumbar Disc Herniation |
title_sort |
extraforaminal approach for the management of far lateral lumbar disc herniation |
publisher |
Egyptian Spine Association |
publishDate |
2017 |
url |
https://doaj.org/article/8cdf05db3e2441ee8f96c63e2f0f73a4 |
work_keys_str_mv |
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