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Acta Neurochirurgica

, Volume 154, Issue 4, pp 711–714 | Cite as

Translaminar approach to cranio-laterally herniated lumbar disc prolapse

  • C. SchulzEmail author
  • A. Abdeltawab
  • U. M. Mauer
How I Do It

Abstract

Background

For cranio-laterally extruded disc fragments, a far enlargement of the standard interlaminar fenestration is necessary. This strategy harbours a potential risk for relevant destruction of the facet joints and postsurgical instability could be the consequence. For preserving the facet joint, a limited approach through the hemilamina is possible.

Method

After the standard paramedian soft tissue approach and retraction of the paravertebral muscles laterally, the hemilamina is exposed and fenestrated, preserving the bony borders of the lamina. The disc herniation can be extracted via this lamina fenestration.

Conclusion

This surgical strategy is safe and effective in approaching cranially herniated disc fragments.

Keywords

Lumbar spine Disc herniation Translaminar sequestrectomy 

Notes

Conflicts of interest

None.

Supplementary material

ESM 1

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References

  1. 1.
    Bernucci C, Giovanelli M (2007) Translaminar microsurgical approach for lumbar herniated nucleus pulposus (HNP) in the “hidden zone”: clinical and radiologic results in a series of 24 patients. Spine (Phila Pa 1976) 32(2):281–284CrossRefGoogle Scholar
  2. 2.
    Di Lorenzo N, Porta F, Onnis G, Cannas A, Arbau G, Maleci A (1998) Pars interarticularis fenestration in the treatment of foraminal lumbar disc herniation: a further surgical approach. Neurosurgery 42:87–90PubMedCrossRefGoogle Scholar
  3. 3.
    Garrido E, Connaughton PN (1991) Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg 74:754–756PubMedCrossRefGoogle Scholar
  4. 4.
    Hassler W, Brandner S, Slansky I (1996) Microsurgical management of lateral disc herniations: combined lateral and interlaminar approach. Acta Neurochir (Wien) 138(8):907–910CrossRefGoogle Scholar
  5. 5.
    Papavero L, Langer N, Fritzsche E, Emami P, Westphal M, Kothe R (2008) The translaminar approach to lumbar disc herniations impinging the exiting root. Neurosurgery 62(3 Suppl 1):173–177PubMedCrossRefGoogle Scholar
  6. 6.
    Reulen HJ, Müller A, Ebeling U (1996) Microsurgical anatomy of the lateral approach to extraforaminal lumbar disc herniations. Neurosurgery 39:345–350PubMedCrossRefGoogle Scholar
  7. 7.
    Seiz M, Pechlivanis I, Bag S, Schmieder K, Thome C, Tuettenberg J (2009) Translaminar fenestration for caudally herniated lumbar discs—a technical note. Z Orthop Unfall 147(5):597–599PubMedCrossRefGoogle Scholar
  8. 8.
    Soldner F, Hoelper BM, Wallenfang T, Behr R (2002) The translaminar approach to canalicular and cranio-dorsolateral lumbar disc herniations. Acta Neurochir (Wien) 144(4):315–320CrossRefGoogle Scholar
  9. 9.
    Tessitore E, de Tribolet N (2004) Far-lateral lumbar disc herniation: the microsurgical transmuscular approach. Neurosurgery 54(4):939–942PubMedCrossRefGoogle Scholar
  10. 10.
    Vogelsang JP (2007) The translaminar approach in combination with a tubular retractor system for the treatment of far cranio-laterally and foraminally extruded lumbar disc herniations. Zentralbl Neurochir 68(1):24–28PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.German Federal Armed Forces Medical ServiceMilitary Hospital UlmUlmGermany

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