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A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process

Background and Objectives: The use of minimally invasive retractor systems has significantly decreased the amount of tissue dissection and blood loss, and the duration of post-operative recovery after far-lateral disc herniations (FLDH). In this technical note, the technique of docking the tubular r...

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Autores principales: Echt, Murray, Bakare, Adewale, Fessler, Richard G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145708/
https://www.ncbi.nlm.nih.gov/pubmed/35630057
http://dx.doi.org/10.3390/medicina58050640
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author Echt, Murray
Bakare, Adewale
Fessler, Richard G.
author_facet Echt, Murray
Bakare, Adewale
Fessler, Richard G.
author_sort Echt, Murray
collection PubMed
description Background and Objectives: The use of minimally invasive retractor systems has significantly decreased the amount of tissue dissection and blood loss, and the duration of post-operative recovery after far-lateral disc herniations (FLDH). In this technical note, the technique of docking the tubular retractor on the caudal transverse process is described for an efficient approach with a decreased need for manipulation of the exiting nerve root. Materials and Methods: The case reported is that of a woman affected by a right-sided FLDH at the L4–5 level causing an L4 radiculopathy with weakness and numbness. A review of the literature for FLDH regarding the key anatomy used during a far lateral approach was also performed. Results: The patient showed a significant improvement of her dorsiflexion weakness and radiating leg pain at her 2-week and 5-week post-operative visits, and at a 6-month follow-up she had near-complete relief of her symptoms, including resolution of foot numbness. Prior techniques for tubular microdiscectomy for FLDH report docking on the facet joint, pars interarticularis, and the cranial transverse process. Conclusions: This technical note details that the utility of docking a tubular retractor at the caudal transverse process improves upon already established techniques for minimally invasive tubular discectomy for FLDH.
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spelling pubmed-91457082022-05-29 A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process Echt, Murray Bakare, Adewale Fessler, Richard G. Medicina (Kaunas) Technical Note Background and Objectives: The use of minimally invasive retractor systems has significantly decreased the amount of tissue dissection and blood loss, and the duration of post-operative recovery after far-lateral disc herniations (FLDH). In this technical note, the technique of docking the tubular retractor on the caudal transverse process is described for an efficient approach with a decreased need for manipulation of the exiting nerve root. Materials and Methods: The case reported is that of a woman affected by a right-sided FLDH at the L4–5 level causing an L4 radiculopathy with weakness and numbness. A review of the literature for FLDH regarding the key anatomy used during a far lateral approach was also performed. Results: The patient showed a significant improvement of her dorsiflexion weakness and radiating leg pain at her 2-week and 5-week post-operative visits, and at a 6-month follow-up she had near-complete relief of her symptoms, including resolution of foot numbness. Prior techniques for tubular microdiscectomy for FLDH report docking on the facet joint, pars interarticularis, and the cranial transverse process. Conclusions: This technical note details that the utility of docking a tubular retractor at the caudal transverse process improves upon already established techniques for minimally invasive tubular discectomy for FLDH. MDPI 2022-05-05 /pmc/articles/PMC9145708/ /pubmed/35630057 http://dx.doi.org/10.3390/medicina58050640 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Technical Note
Echt, Murray
Bakare, Adewale
Fessler, Richard G.
A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title_full A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title_fullStr A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title_full_unstemmed A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title_short A Modified Approach for Minimally Invasive Tubular Microdiscectomy for Far Lateral Disc Herniations: Docking at the Caudal Level Transverse Process
title_sort modified approach for minimally invasive tubular microdiscectomy for far lateral disc herniations: docking at the caudal level transverse process
topic Technical Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9145708/
https://www.ncbi.nlm.nih.gov/pubmed/35630057
http://dx.doi.org/10.3390/medicina58050640
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