Abstract
We describe a new surgical route that we call the “crest approach” for treating extraforaminal disc herniation in the lumbar spine. This approach is useful only for the levels above L5-S1. It permits perfect root decompression without any bony resection that would contribute to instability. Muscle retraction and devascularization are reduced. Risk of nerve root lesions is minimal since the herniation is removed before root mobilization. Fifteen patients have been treated using this procedure. In all 15, pain and/or neurologic deficits remitted rapidly with no postoperative complications. In conclusion, the crest approach provides highly satisfactory operating conditions by simplifying exposure and greatly limiting the risk of complications. In our relatively limited experience using this procedure, only satisfactory results have been observed.
Similar content being viewed by others
References
Abdullah AF, Wolber PGH, Warfield JR, Gunadi IK (1988) Surgical management of extreme lateral lumbar disc herniations: review of 138 cases. Neurosurgery 22:648–653
Darden BV, Wade JF, Alexander R, Wood KE, Rhyne AL, Hicks JR (1995) Far lateral disc herniations treated by microscopic fragment excision: technique and results. Spine 20:1500–1505
Kunogi J, Hasue M (1991) Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine 11:1312–1320
Lee CK (1983) Lumbar spinal instability (olisthesis) after extensive posterior spinal decompression. Spine 8:429–433
Maroon JC, Kopitnik TA, Schulhof LA, Abla A, Wilberger JE (1990) Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine. J Neurosurg 72:378–382
Osborn AG, Hood RS, Sherry RG et al (1988) CT/MR spectrum of far lateral and anterior lumbosacral disk herniations. AJNR 9:775–778
Ray CD (1987) The paralateral approach to decompression for lateral stenosis and far lateral lesions of the lumbar spine. In: Watkins RG, Collis JS (eds) Lumbar discectomy and laminectomy. Aspen, Rockville, pp 217–227
Watkins MB (1953) Posterolateral fusion of the lumbar and lumbosacral spine. J Bone Joint Surg [Am] 35: 1014–1018
Wiltse LL, Bateman JG, Hutchinson RH, Nelson WE (1960) The paraspinal sacrospinalis-splitting approach to the lumbar spine. J Bone Joint Surg [Am] 50:919–921
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pointillart, V., Broc, G. & Senegas, J. A novel paraspinal surgical approach for lumbar lateral extraforaminal root entrapment. Eur Spine J 6, 102–105 (1997). https://doi.org/10.1007/BF01358741
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01358741