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Minim Invasive Neurosurg 2010; 53(3): 122-126
DOI: 10.1055/s-0030-1249102
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Approach for Far Lateral Disc Herniations: Results from 20 Patients

J.-M. Voyadzis1 , V. C. Gala2 , F. A. Sandhu1 , R. G. Fessler3
  • 1Department of Neurosurgery, Georgetown University Hospital, Washington, D.C., USA
  • 2Atlanta Brain and Spine Care, Atlanta, GA, USA
  • 3Department of Neurosurgery, Northwestern University Hospitals, Chicago, IL, USA
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Publication History

Publication Date:
31 August 2010 (online)

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Abstract

Background: Far lateral lumbar disc herniations, while infrequent, are a substantial cause of morbidity causing painful radicular syndromes often accompanied by a motor or sensory deficit. Surgical treatment can be challenging technically because of unfamiliar lateral anatomy and the importance of adjacent osseous structures, notably the pars interarticularis and facet joint.

Method: The traditional approach for a far lateral lumbar disc herniation involves a midline incision, wide lateral subperiosteal exposure and partial removal of these structures with the potential for iatrogenic instability. A paramedian approach to the lateral compartment of the disc space is advantageous because it directly targets the pathology. The use of recently developed minimally invasive retractor systems decreases tissue dissection and blood loss and improves postoperative recovery.

Results and Discussion: We present a series of 20 patients who underwent far lateral discectomy using a minimally invasive muscle splitting approach.

Key words

far lateral - lumbar disc herniation - minimally invasive surgery

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Correspondence

J.-M. VoyadzisMD 

Department of Neurosurgery

Georgetown University Hospital

7 PHC

3800 Reservoir Road, NW

Washington

D.C.20007

USA

Phone: +1/202/444 4972

Fax: +1/202/444 7344

Email: jmvoyadzis@hotmail.com