Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach

Back Ground Data: Far lateral lumbar disc herniation is a unique entity. It needs special care in designing the best surgical approach. Many limited approached have been advocated. We report a case series treated by a minimally invasive approach. Purpose: to evaluate the efficacy and safety of minim...

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Autores principales:	Yasser Allam, Tarek El-Fiky
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2012
Materias:	Far lateral lumbar disc herniation Extraforaminal lumbar disc herniation Minimally invasive approach microscopic discectomy Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/f4554a1f72c24c7da58dc85cb00d1863
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spelling	oai:doaj.org-article:f4554a1f72c24c7da58dc85cb00d18632021-12-02T04:03:43ZTreatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive ApproachDOI:10.21608/ESJ.2012.37852314-89502314-8969https://doaj.org/article/f4554a1f72c24c7da58dc85cb00d18632012-04-01T00:00:00Zhttp://esj.journals.ekb.eg/article_3785.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Back Ground Data: Far lateral lumbar disc herniation is a unique entity. It needs special care in designing the best surgical approach. Many limited approached have been advocated. We report a case series treated by a minimally invasive approach. Purpose: to evaluate the efficacy and safety of minimally invasive approach in treatment of far lateral lumbar disc herniation. Study Design: Prospective analytic study. Methods: 25 patients suffering from far lateral disc herniation (extra-foraminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinal muscles are spread by dilators, until a working channel of 11 mm inner diameter and 14 mm outer diameter can be placed. All further steps are performed through this channel under illumination and control of the operating microscope. The mean follow up period was one year, and patients were evaluated by using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Results: The average surgical time was 49.2 minutes. The ODI improved from 29.96 (preoperative) to 12.12 (post-operative). The VAS of back pain improved from 6.24 (pre-operative) to 3.4 (post-operative).The VAS of leg pain improved from 7.2 (pre-operative) to 2.6 (postoperative). No intra-operative or early postoperative complications occurred. However, only one recurrence happened and could be treated by the same technique. Conclusion: The results from this small series seem to promise that this minimal invasive microscope assisted technique is a practical and valuable alternative to conventional techniques for the treatment of far lateral lumbar disc herniation. The main advantages include: minimal surgical trauma, no effect on the stability of the spine, rapid rehabilitation, short hospital stay and excellent cosmetic outcome. (2012ESJ018)Yasser Allam Tarek El-FikyEgyptian Spine AssociationarticleFar lateral lumbar disc herniationExtraforaminal lumbar disc herniationMinimally invasive approachmicroscopic discectomyNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 2, Iss 1, Pp 1-6 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Far lateral lumbar disc herniation Extraforaminal lumbar disc herniation Minimally invasive approach microscopic discectomy Neurology. Diseases of the nervous system RC346-429
spellingShingle	Far lateral lumbar disc herniation Extraforaminal lumbar disc herniation Minimally invasive approach microscopic discectomy Neurology. Diseases of the nervous system RC346-429 Yasser Allam Tarek El-Fiky Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
description	Back Ground Data: Far lateral lumbar disc herniation is a unique entity. It needs special care in designing the best surgical approach. Many limited approached have been advocated. We report a case series treated by a minimally invasive approach. Purpose: to evaluate the efficacy and safety of minimally invasive approach in treatment of far lateral lumbar disc herniation. Study Design: Prospective analytic study. Methods: 25 patients suffering from far lateral disc herniation (extra-foraminal) were operated according to this technique. Through a small skin incision (1.5 cm), the paraspinal muscles are spread by dilators, until a working channel of 11 mm inner diameter and 14 mm outer diameter can be placed. All further steps are performed through this channel under illumination and control of the operating microscope. The mean follow up period was one year, and patients were evaluated by using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI). Results: The average surgical time was 49.2 minutes. The ODI improved from 29.96 (preoperative) to 12.12 (post-operative). The VAS of back pain improved from 6.24 (pre-operative) to 3.4 (post-operative).The VAS of leg pain improved from 7.2 (pre-operative) to 2.6 (postoperative). No intra-operative or early postoperative complications occurred. However, only one recurrence happened and could be treated by the same technique. Conclusion: The results from this small series seem to promise that this minimal invasive microscope assisted technique is a practical and valuable alternative to conventional techniques for the treatment of far lateral lumbar disc herniation. The main advantages include: minimal surgical trauma, no effect on the stability of the spine, rapid rehabilitation, short hospital stay and excellent cosmetic outcome. (2012ESJ018)
format	article
author	Yasser Allam Tarek El-Fiky
author_facet	Yasser Allam Tarek El-Fiky
author_sort	Yasser Allam
title	Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
title_short	Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
title_full	Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
title_fullStr	Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
title_full_unstemmed	Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach
title_sort	treatment of far lateral lumbar disc herniation via a minimally invasive approach
publisher	Egyptian Spine Association
publishDate	2012
url	https://doaj.org/article/f4554a1f72c24c7da58dc85cb00d1863
work_keys_str_mv	AT yasserallam treatmentoffarlaterallumbardischerniationviaaminimallyinvasiveapproach AT tarekelfiky treatmentoffarlaterallumbardischerniationviaaminimallyinvasiveapproach
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Treatment of Far Lateral Lumbar disc Herniation Via a Minimally invasive Approach

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