Abstract
Objective: This paper aims to demonstrate the feasibility and efficacy of a minimal invasive approach by using a muscle dilator system for the treatment of lateral lumbar disc herniations.
Methods: A retrospective analysis of 38 cases with lateral lumbar disc herniations that were treated the METRx-System was performed. Patients were assessed preoperatively and postoperatively with the visual analogue scale (VAS) for leg pain. Follow up ranged from 6 to 24 months.
Results: No intraoperative complications were observed. Operation time and intraoperative blood loss were minimized. In 37 cases VAS scores were significantly lower after the procedure. A single patient had to be reoperated due to insufficient removal of the herniated disc material.
Conclusion: The reported minimal invasive technique is a safe and efficient alternative to conventional methods for the treatment of lateral lumbar disc herniations.
Key words
lateral disc herniation - METRx
References
-
1
Kuh SU, Kim YS, Cho YE, Yoon YS, Jin BH, Kim KS, Chin DK.
Surgical treatments for lumbar disc disease in adolescent patients; chemonucleolysis/microsurgical discectomy/PLIF with cages.
Yonsei Med J.
2005;
46
125-132
-
2
Quaglietta P, Cassitto D, Corriero AS, Corriero G.
Paraspinal approach to the far lateral disc herniations: retrospective study on 42 cases.
Acta Neurochir Suppl.
2005;
92
115-119
-
3
Tessitore E, Tribolet N de.
Far-lateral lumbar disc herniation: the microsurgical transmuscular approach.
Neurosurgery.
2004;
54
939-942
-
4
Ruetten S, Komp M, Godolias G.
A new full-endoscopic technique for the interlaminar operation of lumbar disc herniations using 6-mm endoscopes: prospective 2-year results of 331 patients.
Minim Invas Neurosurg.
2006;
49
80-87
-
5
Ruetten S, Komp M, Godolias G.
An extreme lateral access for the surgery of lumbar disc herniations inside the spinal canal using the full-endoscopic uniportal transforaminal approach-technique and prospective results of 463 patients.
Spine.
2005;
30
2570-2578
-
6
Cervellini P, Luca GP De, Mazzetto M, Colombo F.
Micro-endoscopic-discectomy (MED) for far lateral disc herniation in the lumbar spine. Technical note.
Acta Neurochir Suppl.
2005;
92
99-101
-
7
Chiu JC.
Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis.
Surg Technol Int.
2004;
13
276-286
-
8
Hsieh PC, Wang CH.
Posterior endoscopic lumbar discectomy using a thoracoport as a tubular retractor.
Minim Invas Neurosurg.
2004;
47
319-323
-
9
Yeung AT, Yeung CA.
Advances in endoscopic disc and spine surgery: foraminal approach.
Surg Technol Int.
2003;
11
255-263
-
10
Isaacs RE, Podichetty V, Fessler RG.
Microendoscopic discectomy for recurrent disc herniations.
Neurosurg Focus.
2003;
15
E11
-
11
Epimenio RO, Giancarlo D, Giuseppe T, Raffaelino R, Luigi F.
Extraforaminal lumbar herniation: “far lateral” microinvasive approach retrospective study.
Spinal Disord Tech.
2003;
16
534-538
-
12
Greiner-Perth R, Bohm H, Allam Y.
A new technique for the treatment of lumbar far lateral disc herniation: technical note and preliminary results.
Eur Spine J.
2003;
12
320-324
-
13
Palmer S.
Use of a tubular retractor system in microscopic lumbar discectomy: 1 year prospective results in 135 patients.
Neurosurgery Focus.
2002;
13
E5
-
14
Arts MP, Peul WC, Brand R, Koes BW, Thomeer RT.
Cost-effectiveness of microendoscopic discectomy versus conventional open discectomy in the treatment of lumbar disc herniation: a prospective randomised controlled trial.
BMC Musculoskelet Disord.
2006;
7
42
-
15
Obenchain TG.
Speculum lumbar extraforaminal microdiscectomy.
Spine J.
2001;
1
415-420
, ; discussion: 420-421
-
16
Meinke AK.
Totally extraperitoneal laparoendoscopic repair of lumbar hernia.
Surg Endosc.
2003;
17
734-737
-
17
Song J, Park Y.
Ligament-sparing lumbar microdiscectomy: technical note.
Surg Neurol.
2000;
53
592-596
, ; discussion: 596-597
-
18
Placzek R, Birken L, Morlock M, Ruther W, Schneider E.
Effect of various cylinder diameters of implants for lumbar inter-corporeal spinal fusion on compressive strength on the FSU model.
Biomed Tech (Berl).
1998;
43
253-256
-
19
Obenchain TG, Cloyd D.
Laparoscopic lumbar discectomy: description of transperitoneal and retroperitoneal techniques.
Neurosurg Clin N Am.
1996;
7
77-85
Correspondence
V. I. VougioukasMD
Department of Neurosurgery Neurocenter
Albert-Ludwigs University of Freiburg
Breisacherstrasse 64
79106 Freiburg im Breisgau
Germany
Telefon: +49/761/270 50 01
Fax: +49/761/270 50 80
eMail: vvougio@nz.ukl.uni-freiburg.de