Extraforaminal L5-S1 Disc Herniation Treated by Endoscopic Transfacet Approach. Case Report and Technical Note

Authors

DOI:

https://doi.org/10.15417/issn.1852-7434.2024.89.1.1856

Keywords:

Endoscopy, minimally invasive, spine, lumbar, disc disease

Abstract

Extraforaminal L5-S1 disc herniations are usually difficult to treat due to their complicated access and risk of nerve injury. We present the case of a patient with left L5-S1 disc disease who was treated by endoscopic discectomy using a transfacet Wiltse-like approach. This method provides safe access to L5-S1 extraforaminal herniations while avoiding manipulation and irritation of the L5 root.

Downloads

Download data is not yet available.

Author Biographies

  • Máximo de Zavalía, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

    Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

  • Enrique Gobbi, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

    Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

  • Santiago Yeregui, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

    Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

References

Jang JS, An SH, Lee SH. Transforaminal percutaneous endoscopic discectomy in the treatment of foraminal and

extraforaminal lumbar disc herniations. J Spinal Disord Tech 2006;19(5):338-43. https://doi.org/10.1097/01.bsd.0000204500.14719.2e DOI: https://doi.org/10.1097/01.bsd.0000204500.14719.2e

Postacchini F, Cinotti G, Gumina S. Microsurgical excision of lateral lumbar disc herniation through an interlaminar approach. J Bone Joint Surg Br 1998;80(2):201-7. https://doi.org/10.1302/0301-620x.80b2.8163 DOI: https://doi.org/10.1302/0301-620X.80B2.8163

Abdullah AF, Ditto EW 3rd, Byrd EB, Williams R. Extreme-lateral lumbar disc herniations. Clinical syndrome and

special problems of diagnosis. J Neurosurg 1974;41(2):229-34. https://doi.org/10.3171/jns.1974.41.2.0229 DOI: https://doi.org/10.3171/jns.1974.41.2.0229

Siebner HR, Faulhauer K. Frequency and specific surgical management of far lateral lumbar disc herniations. Acta Neurochir (Wien) 1990;105(3-4):124-31. https://doi.org/10.1007/BF01669995 DOI: https://doi.org/10.1007/BF01669995

Yeom JS, Kim KH, Hong SW, Park KW, Chang BS, Lee CK, et al. A minimally invasive technique for L5-S1

intraforaminal disc herniations: microdiscectomy with a tubular retractor via a contralateral approach. J Neurosurg Spine 2008;8(2):193-8. https://doi.org/10.3171/SPI/2008/8/2/193 DOI: https://doi.org/10.3171/SPI/2008/8/2/193

Garrido E, Connaughton PN. Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg

;74(5):754-6. https://doi.org/10.3171/jns.1991.74.5.0754 DOI: https://doi.org/10.3171/jns.1991.74.5.0754

Jane JA, Haworth CS, Broaddus WC, Lee JH, Malik J. A neurosurgical approach to far-lateral disc herniation.

Technical note. J Neurosurg 1990;72(1):143-4. https://doi.org/10.3171/jns.1990.72.1.0143 DOI: https://doi.org/10.3171/jns.1990.72.1.0143

Kunogi J, Hasue M. Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine (Phila Pa 1976) 1991;16(11):1312-20. https://doi.org/10.1097/00007632-199111000-00012 DOI: https://doi.org/10.1097/00007632-199111000-00012

Müller A, Reulen HJ. A paramedian tangential approach to lumbosacral extraforaminal disc herniations.

Neurosurgery 1998;43(4):854-61; discussion 861-2. https://doi.org/10.1097/00006123-199810000-00077 DOI: https://doi.org/10.1097/00006123-199810000-00077

O’Brien MF, Peterson D, Crockard HA. A posterolateral microsurgical approach to extreme-lateral lumbar disc

herniation. J Neurosurg 1995;83(4):636-40. https://doi.org/10.3171/jns.1995.83.4.0636 DOI: https://doi.org/10.3171/jns.1995.83.4.0636

Kapetanakis S, Gkasdaris G, Angoules AG, Givissis P. Transforaminal percutaneous endoscopic discectomy using transforaminal endoscopic spine system technique: Pitfalls that a beginner should avoid. World J Orthop

;8(12):874-80. https://doi.org/10.5312/wjo.v8.i12.874 DOI: https://doi.org/10.5312/wjo.v8.i12.874

Yeung AT, Tsou PM. Posterolateral endoscopic excision for lumbar disc herniation: Surgical technique, outcome, and complications in 307 consecutive cases. Spine (Phila Pa 1976) 2002;27(7):722-31. https://doi.org/10.1097/00007632-200204010-00009 DOI: https://doi.org/10.1097/00007632-200204010-00009

Kikuchi S, Sato K, Konno S, Hasue M. Anatomic and radiographic study of dorsal root ganglia. Spine (Phila Pa

1994;19(1):6-11. https://doi.org/10.1097/00007632-199401000-00002 DOI: https://doi.org/10.1097/00007632-199401000-00002

Vanderlinden RG. Subarticular entrapment of the dorsal root ganglion as a cause of sciatic pain. Spine (Phila Pa 1976) 1984;9(1):19-22. https://doi.org/10.1097/00007632-198401000-00006 DOI: https://doi.org/10.1097/00007632-198401000-00006

Dasenbrock HH, Juraschek SP, Schultz LR, Witham TF, Sciubba DM, Wolinsky JP, et al. The efficacy of minimally

invasive discectomy compared with open discectomy: a meta-analysis of prospective randomized controlled trials. J Neurosurg Spine 2012;16(5):452-62. https://doi.org/10.3171/2012.1.SPINE11404 DOI: https://doi.org/10.3171/2012.1.SPINE11404

Wang B, Lü G, Patel AA, Ren P, Cheng I. An evaluation of the learning curve for a complex surgical technique: the full endoscopic interlaminar approach for lumbar disc herniations. Spine J 2011;11(2):122-30.

https://doi.org/10.1016/j.spinee.2010.12.006 DOI: https://doi.org/10.1016/j.spinee.2010.12.006

Nie H, Zeng J, Song Y, Chen G, Wang X, Li Z, et al. Percutaneous endoscopic lumbar discectomy for L5-S1 disc

herniation via an interlaminar approach versus a transforaminal approach: A prospective randomized controlled

study with 2-year follow up. Spine (Phila Pa 1976) 2016;41 Suppl 19:B30-B37. https://doi.org/10.1097/BRS.0000000000001810 DOI: https://doi.org/10.1097/BRS.0000000000001810

Yang X, Liu X, Zheng Y. Surgical treatment of thoracic disc herniations using a modified transfacet approach.

Indian J Orthop 2014;48(2):158-62. https://doi.org/10.4103/0019-5413.128756 DOI: https://doi.org/10.4103/0019-5413.128756

Published

2024-02-15

Issue

Section

Nota técnica

Categories

How to Cite

Extraforaminal L5-S1 Disc Herniation Treated by Endoscopic Transfacet Approach. Case Report and Technical Note. (2024). Revista de la Asociación Argentina de Ortopedia Y Traumatología, 89(1), 70-75. https://doi.org/10.15417/issn.1852-7434.2024.89.1.1856

Most read articles by the same author(s)

1 2 > >>