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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Autores principales: Al Moataz El-Sabrout, Mohammad El-Sharkawi, Mohamed El-Meshtawy, Romany Zaki
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Lenguaje:EN
Publicado: Egyptian Spine Association 2017
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spelling 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)
institution DOAJ
collection DOAJ
language EN
topic far lateral lumbar disc
extraforaminal approach
paramedian approach
Neurology. Diseases of the nervous system
RC346-429
spellingShingle 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
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