Extraforaminal L5-S1 Disc Herniation Treated by Endoscopic Transfacet Approach. Case Report and Technical Note
Article Sidebar
Published:
Feb 15, 2024
Keywords:
Endoscopy, minimally invasive, spine, lumbar, disc disease
Main Article Content
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.
Metrics
Metrics Loading ...
Article Details
How to Cite
de Zavalía, M., Gobbi, E., & Yeregui, S. (2024). Extraforaminal L5-S1 Disc Herniation Treated by Endoscopic Transfacet Approach. Case Report and Technical Note. 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
Section
Nota técnica
Copyright (c) 2024 Revista de la Asociación Argentina de Ortopedia y Traumatología
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
References
1. 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
2. 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
3. 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
4. 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
5. 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
6. Garrido E, Connaughton PN. Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg
1991;74(5):754-6. https://doi.org/10.3171/jns.1991.74.5.0754
7. 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
8. 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
9. 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
10. 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
11. 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
2017;8(12):874-80. https://doi.org/10.5312/wjo.v8.i12.874
12. 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
13. Kikuchi S, Sato K, Konno S, Hasue M. Anatomic and radiographic study of dorsal root ganglia. Spine (Phila Pa
1976) 1994;19(1):6-11. https://doi.org/10.1097/00007632-199401000-00002
14. 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
15. 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
16. 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
17. 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
18. 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
extraforaminal lumbar disc herniations. J Spinal Disord Tech 2006;19(5):338-43. https://doi.org/10.1097/01.bsd.0000204500.14719.2e
2. 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
3. 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
4. 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
5. 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
6. Garrido E, Connaughton PN. Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg
1991;74(5):754-6. https://doi.org/10.3171/jns.1991.74.5.0754
7. 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
8. 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
9. 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
10. 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
11. 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
2017;8(12):874-80. https://doi.org/10.5312/wjo.v8.i12.874
12. 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
13. Kikuchi S, Sato K, Konno S, Hasue M. Anatomic and radiographic study of dorsal root ganglia. Spine (Phila Pa
1976) 1994;19(1):6-11. https://doi.org/10.1097/00007632-199401000-00002
14. 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
15. 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
16. 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
17. 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
18. 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