Conjoint Nerve Root an Intraoperative Challenge in Minimally Invasive Tubular Discectomy.

Autor: Sharma A; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Singh V; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Agrawal R; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Mangale N; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Deepak P; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Savla J; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India., Jaiswal A; Department of Orthopedic and Spine Surgery, Dr. Babasaheb Ambedkar Central Railway Hospital, Mumbai, India.
Jazyk: angličtina
Zdroj: Asian spine journal [Asian Spine J] 2021 Aug; Vol. 15 (4), pp. 545-549. Date of Electronic Publication: 2020 Nov 16.
DOI: 10.31616/asj.2020.0250
Abstrakt: Conjoint nerve root (CNR) is an embryological nerve root anomaly that mainly involves the lumbosacral region. The presence of CNR during tubular discectomy raises the chances of failure in spinal surgery and the risk of neural injuries. Tubular discectomy can be challenging in the presence of CNR owing to limited visualization. Here, we present a technical note on two cases of L5-S1 disc prolapse in the presence of conjoint S1 nerve root that was operated via a minimally invasive tubular approach. Any intraoperative suspicion of CNR while using the tubular approach should prompt the surgeon to perform a thorough tubular decompression prior to nerve root retraction. In patients with a large disc, disc should be approached via the axilla because the axillary area between the dura and the medial boarder of the root is very easy to approach in the presence of CNR. Safe performance of tubular discectomy is possible even in the presence of CNR in the lumbar spine.
Databáze: MEDLINE
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