J Neurol Surg A Cent Eur Neurosurg 2021; 82(01): 027-033
DOI: 10.1055/s-0040-1714367
Original Article

Surgical Outcomes of Extraforaminal Microdiskectomy by Midline Incision for Far-Lateral Lumbar Disk Herniation

Ismail Yüce
1   Vocational School of Health Services, Acibadem Mehmet Ali Aydinlar Universitesi, Istanbul, Turkey
Okan Kahyaoğlu
2   Acibadem Healthcare Group, Fulya Hospital, Istanbul, Turkey
Halit Çavuşoğlu
1   Vocational School of Health Services, Acibadem Mehmet Ali Aydinlar Universitesi, Istanbul, Turkey
Yunus Aydın
2   Acibadem Healthcare Group, Fulya Hospital, Istanbul, Turkey
› Author Affiliations
Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.


Background Far-lateral lumbar disk herniation (FLDH) is defined as a disk herniation located laterally to the medial wall of the pedicle. The aim of our study is to describe the extraforaminal microdiskectomy by midline incision for FLDH, which does not include laminotomy–partial facetectomy, and to evaluate mid-term surgical outcomes.

Methods 107 patients who underwent surgery for FLDH by midline incision for the first time between 2012 and 2017 were included in our study. The assessment of neurological status of the patients was done by physical examination, preoperative Oswestry Disability Index (ODI), Visual Analog Scala (VAS) scores, and magnetic resonance images. They were then followed-up postoperatively and at 12 months with VAS and ODI tests.

Result 58 (54.2%) patients were male and 49 (45.8%) were female. The mean age at the time of surgery was 55.0 ± 8.6 years. The mean ODI scale score was 32.4 ± 6.2 preoperatively, 11.4 ± 2.1 early postoperatively, and 9.7 ± 2.2 in late postoperative follow-up (statistically significant, p = 0.001). The average VAS was 7.51 ± 1.1 preoperatively, 2.74 ± 0.7 early postoperatively, and 0.68 ± 0.08 in late postoperative follow-up (statistically significant, p = 0.001). The average operative time was 41 ± 7 (37 to 58) minutes.

Conclusions The extraforaminal microdiskectomy without laminotomy by midline incision is a minimally invasive approach for FLDH. Our technique allows a sufficient and safe decompression of the neural structures, and thus results in a significant reduction of the symptoms and disability

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

This study was performed with clinical data collected from patient files collected retrospectively. For this type of study, formal consent is not required. All patients were informed for the procedure and the study.

Publication History

Received: 29 May 2019

Accepted: 02 December 2019

Article published online:
06 November 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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