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Minim Invasive Neurosurg 2007; 50(3): 160-162
DOI: 10.1055/s-2007-985143
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Approach for the Treatment of Lateral Lumbar Disc Herniations. Technique and Results

E. Kogias 1 , V. I. Vougioukas 1 , U. Hubbe 1 , M.-E. Halatsch 2
  • 1Department of Neurosurgery, Albert-Ludwigs University of Freiburg, Freiburg, Germany
  • 2Department of Neurosurgery, Ruprecht-Karls University of Heidelberg, Heidelberg, Germany
Further Information

Publication History

Publication Date:
19 September 2007 (online)

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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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 3 Tessitore E, Tribolet N de. Far-lateral lumbar disc herniation: the microsurgical transmuscular approach.  Neurosurgery. 2004;  54 939-942
    CrossrefPubMedGoogle Scholar
  • 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
    Article in Thieme ConnectPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 7 Chiu JC. Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis.  Surg Technol Int. 2004;  13 276-286
    PubMedGoogle Scholar
  • 8 Hsieh PC, Wang CH. Posterior endoscopic lumbar discectomy using a thoracoport as a tubular retractor.  Minim Invas Neurosurg. 2004;  47 319-323
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Yeung AT, Yeung CA. Advances in endoscopic disc and spine surgery: foraminal approach.  Surg Technol Int. 2003;  11 255-263
    PubMedGoogle Scholar
  • 10 Isaacs RE, Podichetty V, Fessler RG. Microendoscopic discectomy for recurrent disc herniations.  Neurosurg Focus. 2003;  15 E11
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 15 Obenchain TG. Speculum lumbar extraforaminal microdiscectomy.  Spine J. 2001;  1 415-420 , ; discussion: 420-421
    CrossrefPubMedGoogle Scholar
  • 16 Meinke AK. Totally extraperitoneal laparoendoscopic repair of lumbar hernia.  Surg Endosc. 2003;  17 734-737
    CrossrefPubMedGoogle Scholar
  • 17 Song J, Park Y. Ligament-sparing lumbar microdiscectomy: technical note.  Surg Neurol. 2000;  53 592-596 , ; discussion: 596-597
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 19 Obenchain TG, Cloyd D. Laparoscopic lumbar discectomy: description of transperitoneal and retroperitoneal techniques.  Neurosurg Clin N Am. 1996;  7 77-85
    PubMedGoogle Scholar

Correspondence

V. I. VougioukasMD 

Department of Neurosurgery Neurocenter

Albert-Ludwigs University of Freiburg

Breisacherstrasse 64

79106 Freiburg im Breisgau

Germany

Phone: +49/761/270 50 01

Fax: +49/761/270 50 80

Email: vvougio@nz.ukl.uni-freiburg.de