bShandong First Medical University, Shandong, Jinan, 250000, ChinaaDepartment of Spine Surgery, The First Affiliated Hospital, Shandong First Medical University, Shandong, Jinan, 250000, China
[Objective] To introduce the surgical technique and preliminary clinical results of modified microscopy-channel assisted discectomy of extreme lateral lumbar disc herniation. [Methods] A patient underwent the abovesaid operation. The patient was placed in a prone position with a para-midline approach made. A minimally invasive channel was placed on the shoulder of the superior facet of the lower vertebrae to exposure the upper lateral articular process, part of the lateral isthmus of the upper v...更多
[Objective] To introduce the surgical technique and preliminary clinical results of modified microscopy-channel assisted discectomy of extreme lateral lumbar disc herniation. [Methods] A patient underwent the abovesaid operation. The patient was placed in a prone position with a para-midline approach made. A minimally invasive channel was placed on the shoulder of the superior facet of the lower vertebrae to exposure the upper lateral articular process, part of the lateral isthmus of the upper vertebrae, and the inter-transverse ligament. With the aid of microscope, the upper lateral margin of the superior articular process was removed, while the isthmus remained, to expose the external outlet of the foramen. Turning the channel forward the foramen and the internal foramen region, the herniated disc was removed and the nerve root was released. [Results] The operation was conducted successfully, with operation time of 78 min and intraoperative blood loss of 50 mL. The pain of the affected limb disappeared after the operation, while the straight leg raise test turned to be negative, and the modified MacNab grade was marked as best. The visual analogue scale decreased from 9 before surgery to 3 2 days after operation and 1 a month after surgery. Postoperative CT showed that the articular surface of the facet and the isthmus of the lamina were intact. [Conclusion] This modified microscope -channel assisted discectomy for extreme lateral lumbar disc herniation has the advantages of minimally invasive surgery, direct and precise nerve decompression, and few impact on the stability of the lumbar spine.收起
