Lateral Lumbar Disc Herniations Treated With a Paraspinal Approach

Abstract

In this independent review, at an average of 5.5 years after surgical excision of a lateral zone disc herniation using a paraspinal approach, 51 of 60 patients (85%) were satisfied with the results. Pain was eliminated in 36 (60%) and reduced in all but 3 (5%). Two-thirds of patients had no residual weakness or numbness. Thirty patients (50%) developed some new low-grade back pain, 17 (28%) developed some radicular pain, 9 (19%) developed some degree of radiographic instability, and 9 (15%) required further operative procedures. Based on this information, surgeons should be able to provide realistic expectations for their patients regarding outcomes. Based on our review of the literature, results using the paraspinal window appear similar, but not superior, to other available techniques, and the choice of approach should be based on the comfort of the surgeon.

Mapeamento do trajeto extraforaminal da raiz L4 no espaço intertransversário L4-L5 através do acesso paramediano à coluna vertebral

“…Clinical studies such as the one by Bradley and cols. (15) confirmed good results with the use of paraspinal port for treating end-lateral lumbar disc hernia, with up to 85% of their patients showing relative satisfact i o n r e g a r d i n g quality of life and resolution of the painful picture. Poor surgical fam i l i a r i t y, d e e p dissection, poor visualization, difficulties in enucleating intervertebral disc, and the potential risk of injury to emergent nervous root are some of its disadvantages.…”

Ultra-long-term outcome of surgically treated far-lateral, extraforaminal lumbar disc herniations: a single-center series

“…Porchet, evaluating the largest series of patients after 4.2 years, found excellent and good outcomes in 73% of his 202 patients [19]. More favorable are the reports of Weiner [27] and Ozveren [18] with excellent and good results in 85 and 100%, respectively, of their patients after 5-8 years. Epstein, comparing different surgical procedures, found excellent and good results after 5 years ranging from 68 to 79%.…”

Avaliação da relação entre parâmetros antropométricos (peso e altura) e a topografia da raiz de L4 no espaço intertransversário L4-L5 através do acesso paramediano à coluna vertebral- Um estudo anatômico em vinte e um cadáveres

“…Clinical studies such as the one by Bradley and cols. (15) confirmed good outcomes with the use of the paraspinal port for treating far lateral lumbar disc hernias, with up to 85% of the patients presenting…”