Extraforaminal L5-S1 Disc Herniation Treated by Endoscopic Transfacet Approach. Case Report and Technical Note

  • Máximo de Zavalía Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-4022-4100
  • Enrique Gobbi Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-7310-6170
  • Santiago Yeregui Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina https://orcid.org/0009-0005-8992-0368
DOI: https://doi.org/10.15417/issn.1852-7434.2024.89.1.1856
Keywords: Endoscopy, minimally invasive, spine, lumbar, disc disease

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.

Author Biographies

Máximo de Zavalía, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina
Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina
Enrique Gobbi, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina
Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina
Santiago Yeregui, Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina
Spine Unit, Orthopedics and Traumatology Service, Hospital Universitario CEMIC, Grupo Médico Vertebral, Autonomous City of Buenos Aires, Argentina

References

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

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

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

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

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

Garrido E, Connaughton PN. Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg

;74(5):754-6. https://doi.org/10.3171/jns.1991.74.5.0754

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

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

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

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

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

;8(12):874-80. https://doi.org/10.5312/wjo.v8.i12.874

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

Kikuchi S, Sato K, Konno S, Hasue M. Anatomic and radiographic study of dorsal root ganglia. Spine (Phila Pa

1994;19(1):6-11. https://doi.org/10.1097/00007632-199401000-00002

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

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

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

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

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

Published
2024-02-15
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
Issue
Vol 89 No 1 (2024): SAPCV
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.