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Extraforaminal Disk Herniation Treatment with Surgical Exploration by Unilateral Intertransversarii Microsurgical Approach

  • Conference paper
Trends in Reconstructive Neurosurgery

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 124))

  • 2809 Accesses

Abstract

Background

In this study we evaluated the role of a unilateral intertransversarii microsurgical approach for the treatment of extraforaminal lumbar disk herniations (ELDHs), with short-, medium-, and long-term follow-up.

Methods

We retrospectively evaluated 96 patients who had undergone surgery for ELDH between 2001 and 2012 at our Institution. All the patients had been examined before the intervention, immediately after, and at 6 weeks, 6 months, and 18 months after the intervention.

All the patients underwent surgical exploration with a unilateral intertransversarii microsurgical approach. After a midline incision was made, the paraspinal muscles were retracted laterally up to the transverse process, in order to visualize the intertransversarii ligament. Removal of this ligament allows microsurgical exposure of the extraforaminal pathology. If necessary, interlaminar microsurgical exploration is performed in the same session.

Results

At 6-week postoperative follow-up we noted a significant decrease of pain both in patients who suffered from leg pain and in patients who reported back pain. Also, sensory and motor deficits had improved considerably. At 6-month postoperative follow-up we observed a further improvement in the clinical conditions of almost all patients. At the 18-month postoperative follow-up we observed a very low incidence of relapse of neurological symptoms.

Conclusion

Our technique can be reasonably proposed because of its low morbidity, fast recovery, and short hospital stay.

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Conflict of Interest Statement

We declare that we have no conflicts of interest.

Author information

Authors and Affiliations

  1. Section of Neurosurgery, Department of Clinical Neurosciences, N.C.L. Neurological Center of Latium, Via Patrica 15, Rome, 00178, Italy

    Aldo Spallone, A. Nardella & L. Lavorato

  2. Department of Biomedicine, University of Rome “Tor Vergata”, Rome, Italy

    Aldo Spallone

  3. Insitute of Neurosurgery, Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi MD

  4. Section of Neurophysiology, Department of Neurology, IRCCS Neuromed, Pozzilli, IS, Italy

    A. Nardella

Authors
  1. Aldo Spallone
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  2. Massimiliano Visocchi MD
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  3. A. Nardella
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  4. L. Lavorato
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Corresponding author

Correspondence to Aldo Spallone .

Editor information

Editors and Affiliations

  1. Institute of Neurosurgery Medical School, Catholic University of Rome, Rome, Italy

    Massimiliano Visocchi

  2. Dept. of Neurosurgery, Christian-Albrechts-University of Kiel, Kiel, Germany

    H. Maximilian Mehdorn

  3. Department of Neurological Surgery, Nihon University, Tokyo, Japan

    Yoichi Katayama

  4. Medical Faculty University of Münster, Münster, Germany

    Klaus R. H. von Wild

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Spallone, A., Visocchi, M., Nardella, A., Lavorato, L. (2017). Extraforaminal Disk Herniation Treatment with Surgical Exploration by Unilateral Intertransversarii Microsurgical Approach. In: Visocchi, M., Mehdorn, H.M., Katayama, Y., von Wild, K.R.H. (eds) Trends in Reconstructive Neurosurgery. Acta Neurochirurgica Supplement, vol 124. Springer, Cham. https://doi.org/10.1007/978-3-319-39546-3_10

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  • DOI: https://doi.org/10.1007/978-3-319-39546-3_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-39545-6

  • Online ISBN: 978-3-319-39546-3

  • eBook Packages: MedicineMedicine (R0)

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