Minimally invasive far lateral tubular microdiscectomy: surgical technique and case series of 176 patients.

Autor: Chau AMT; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Lerch A; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia. a.lerch@uq.edu.au.; The University of Queensland, Brisbane, Australia. a.lerch@uq.edu.au., Waser B; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Green L; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Papacostas J; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Tsahtsarlis A; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., McMillen J; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Campbell R; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Wood M; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia., Amato D; Brisbane Clinical Neuroscience Centre, Mater Hospital, South Brisbane, QLD, Australia.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Nov; Vol. 33 (11), pp. 4385-4391. Date of Electronic Publication: 2024 Aug 19.
DOI: 10.1007/s00586-024-08450-z
Abstrakt: Background: Far lateral (extraforaminal) disc herniations comprise approximately 10% of symptomatic lumbar disc herniations. They represent operative challenges due to accessibility and surgical unfamiliarity. Surgical strategies in the past have included open discectomy and posterior lumbar interbody fusion. Tubular microdiscectomies have gained traction due to their minimally invasive advantages, including reduced morbidity, pain and length of hospital stay.
Methods: We report our retrospective single institution consecutive case series of tubular far lateral microdiscectomies. One hundred and seventy-six patients were operated on over an eight-year period. Clinical outcomes were assessed after institutional ethics approval. We additionally describe our surgical technique with an illustrative video case.
Results: Over a mean follow-up of 21 weeks, 77% of patients had good or excellent clinical outcomes according to the MacNab criteria. 12% of patients underwent reoperation at the index level for symptom recurrence or persistence. Mean length of hospital stay was 1.3 days. There was a 1% rate of both postoperative haematoma and infection. Mean operation duration was 86 minutes.
Conclusion: This case series represents the largest currently reported in the literature. Minimally invasive microdiscectomies performed through tubes allow for precise localisation, reduced tissue disruption and favourable clinical outcomes. Our results appear consistent with a review of the literature, demonstrating the safety and efficacy of this approach.
(© 2024. The Author(s).)
Databáze: MEDLINE
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