Abstract
Minimally invasive lumbar tubular facetectomy can be regarded as a variant of the microdiscectomy that applies to the L3-4 and L2-3 levels, where the narrow shape of the lamina and pars interarticularis forces the surgeon to remove the medial facet in order to access the disc. The L1-2 level can also be approached this way if the disc herniation is not central, since the conus medullaris typically ends at this level and therefore manipulation of the spinal sac must be minimized. This technique can also be used to remove foreign bodies, such as bullets or bone fragments.
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References
T Siu TL, Lin K. Direct tubular lumbar microdiscectomy for far lateral disc herniation: a modified approach. Orthop Surg. 2016;8:301–8. https://doi.org/10.1111/os.12263.
Meredith DS, Huang RC, Nguyen J, Lyman S. Obesity increases the risk of recurrent herniated nucleus pulposus after lumbar microdiscectomy. Spine J. 2010;10:575–80. https://doi.org/10.1016/j.spinee.2010.02.021.
Kogias E, et al. Incidental durotomy in open vs. tubular revision microdiscectomy: a retrospective controlled study on incidence, management and outcome. Clin Spine Surg. 2016. doi:https://doi.org/10.1097/bsd.0000000000000279.
Lee KK, Teo EC. Effects of laminectomy and facetectomy on the stability of the lumbar motion segment. Med Eng Phys. 2004;26:183–92. https://doi.org/10.1016/j.medengphy.2003.11.006.
Natarajan RN, Andersson GB, Patwardhan AG, Andriacchi TP. Study on effect of graded facetectomy on change in lumbar motion segment torsional flexibility using three-dimensional continuum contact representation for facet joints. J Biomech Eng. 1999;121:215–21.
Smith ZA, et al. Biomechanical effects of a unilateral approach to minimally invasive lumbar decompression. PLoS one. 2014;9:e92611. https://doi.org/10.1371/journal.pone.0092611.
Teo EC, Lee KK, Qiu TX, Ng HW, Yang K. The biomechanics of lumbar graded facetectomy under anterior-shear load. IEEE Trans Biomed Eng. 2004;51:443–9. https://doi.org/10.1109/tbme.2003.821009.
Zander T, Rohlmann A, Klockner C, Bergmann G. Influence of graded facetectomy and laminectomy on spinal biomechanics. Eur Spine J. 2003;12:427–34. https://doi.org/10.1007/s00586-003-0540-0.
Garrido E, Connaughton PN. Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg. 1991;74:754–6. https://doi.org/10.3171/jns.1991.74.5.0754.
Frizzell RT, Hadley MN. Lumbar microdiscectomy with medial facetectomy. Techniques and analysis of results. Neurosurg Clin N Am. 1993;4:109–15.
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Electronic Supplementary Material Facetectomy electronic supplementary material
Left L2 facetectomy for removal of large L2–3 herniated disc. Exposure of the lateral aspect of the thecal sac requires removal of the entire medial facet and the medial aspect of the lateral facet. The lateral aspect of the lateral facet is preserved, as it may be a useful anatomical landmark if percutaneous pedicle screw fixation becomes necessary (e.g., to supplement a lateral fusion) (MP4 32513 kb)
Right L2 facetectomy for bullet removal (MP4 214022 kb)
Right L4 facetectomy for bullet removal. The bullet fragment was intradural and attached to the nerve roots (MP4 24974 kb)
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Digiorgio, A., Eggart, M.D., Constantinescu, A., Wilson, J., Tender, G. (2018). Facetectomy. In: Tender, G. (eds) Minimally Invasive Spine Surgery Techniques. Springer, Cham. https://doi.org/10.1007/978-3-319-71943-6_3
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DOI: https://doi.org/10.1007/978-3-319-71943-6_3
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