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Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level
BACKGROUND: Minimally invasive approaches to intra/extraforaminal lumbar disc herniations offer the benefit of less bone removal and reduced nerve root manipulation at the L5-S1 level. Moreover, the potential to better preserve stability. METHODS: Here, we summarized the efficacy of the contralatera...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Scientific Scholar
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282753/ https://www.ncbi.nlm.nih.gov/pubmed/35855125 http://dx.doi.org/10.25259/SNI_400_2022 |
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author | Zekaj, Edvin Saleh, Christian Iess, Guglielmo Ciuffi, Andrea Jaszczuk, Phillip Galbiati, Tommaso Francesco Servello, Domenico |
author_facet | Zekaj, Edvin Saleh, Christian Iess, Guglielmo Ciuffi, Andrea Jaszczuk, Phillip Galbiati, Tommaso Francesco Servello, Domenico |
author_sort | Zekaj, Edvin |
collection | PubMed |
description | BACKGROUND: Minimally invasive approaches to intra/extraforaminal lumbar disc herniations offer the benefit of less bone removal and reduced nerve root manipulation at the L5-S1 level. Moreover, the potential to better preserve stability. METHODS: Here, we summarized the efficacy of the contralateral approach to intraforaminal/extraforaminal lumbar disc herniations particularly focusing on the L5-S1 level. Variables studied included the level of these disc herniations, their locations within the foramina, and the anatomy of the facet joints. RESULTS: A major “pro” for the contralateral interlaminar procedure at the L5-S1 level is that it does not require facet joint removal, or with a spondylotic facet, <30% joint excision, to directly visualize the intraforaminal/ extraforaminal nerve root. It, therefore, reduces the risk of creating iatrogenic instability, while offering a higher certitude of adequate nerve root visualization, decompression, and safer disc removal. CONCLUSION: The contralateral interlaminar approach is more suitable for all types of intra/extraforaminal disc herniations at the L5/S1 level. The most specific benefit of this approach is its avoidance of disruption/significant removal (i.e., <30%) of the facet joint to adequately expose the foraminal L5 nerve root, and more safely remove the intra/extraforaminal disc herniation. |
format | Online Article Text |
id | pubmed-9282753 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Scientific Scholar |
record_format | MEDLINE/PubMed |
spelling | pubmed-92827532022-07-18 Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level Zekaj, Edvin Saleh, Christian Iess, Guglielmo Ciuffi, Andrea Jaszczuk, Phillip Galbiati, Tommaso Francesco Servello, Domenico Surg Neurol Int Technical Notes BACKGROUND: Minimally invasive approaches to intra/extraforaminal lumbar disc herniations offer the benefit of less bone removal and reduced nerve root manipulation at the L5-S1 level. Moreover, the potential to better preserve stability. METHODS: Here, we summarized the efficacy of the contralateral approach to intraforaminal/extraforaminal lumbar disc herniations particularly focusing on the L5-S1 level. Variables studied included the level of these disc herniations, their locations within the foramina, and the anatomy of the facet joints. RESULTS: A major “pro” for the contralateral interlaminar procedure at the L5-S1 level is that it does not require facet joint removal, or with a spondylotic facet, <30% joint excision, to directly visualize the intraforaminal/ extraforaminal nerve root. It, therefore, reduces the risk of creating iatrogenic instability, while offering a higher certitude of adequate nerve root visualization, decompression, and safer disc removal. CONCLUSION: The contralateral interlaminar approach is more suitable for all types of intra/extraforaminal disc herniations at the L5/S1 level. The most specific benefit of this approach is its avoidance of disruption/significant removal (i.e., <30%) of the facet joint to adequately expose the foraminal L5 nerve root, and more safely remove the intra/extraforaminal disc herniation. Scientific Scholar 2022-06-10 /pmc/articles/PMC9282753/ /pubmed/35855125 http://dx.doi.org/10.25259/SNI_400_2022 Text en Copyright: © 2022 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Technical Notes Zekaj, Edvin Saleh, Christian Iess, Guglielmo Ciuffi, Andrea Jaszczuk, Phillip Galbiati, Tommaso Francesco Servello, Domenico Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title | Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title_full | Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title_fullStr | Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title_full_unstemmed | Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title_short | Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level |
title_sort | pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the l5-s1 level |
topic | Technical Notes |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282753/ https://www.ncbi.nlm.nih.gov/pubmed/35855125 http://dx.doi.org/10.25259/SNI_400_2022 |
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