Abstract
The microsurgical approach for removal of prolapsed lumbar disc has gained popularity because of its various advantages. Localisation of the correct level is vital for the success of this procedure. We performed an audit to review our practice regarding the localisation of correct level in lumbar microdiscectomy. Twenty-eight patients were included in this study. Nearly, two-third of the patients had needles as pre-operative marker of localisation and in more than 50% the needle was inserted perpendicular to the floor. When using a needle to localise the spinal level, care should be taken to insert it perpendicular to the floor or parallel to the disc space to avoid approaching the wrong level. The gold standard is an intraoperative lateral fluoroscopy of the spine with a marker in the disc space.
Résumé
L’abord microchirurgical pour l’ablation des prolapsus discaux lombaires a gagné en popularité de par ses nombreux avantages. Le repérage exact du niveau est indispensable au succès. Nous avons réalisé un audit pour revoir notre pratique concernant ce repérage lors de la discectomie microchirurgicale. Vingt huit patients ont été inclus dans cette étude. Environ deux tiers des patients avaient eu une implantation d’aiguille en marquage pré-opératoire et dans plus de 50% des cas, cette aiguille avait été placée perpendiculairement par rapport au sol. Lorsque l’on utilise ce procédé, il faut faire attention de bien placer l’aiguille perpendiculairement par rapport au sol ou bien de façon parallèle au disque, pour éviter toute erreur de niveau. Le « gold standard » consiste à utiliser un contrôle fluoroscopique per-opératoire du rachis avec un marquage de l’espace discal.
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Mohanlal, P., Pal, D. & Timothy, J. Localisation of spinal level in lumbar microdiscectomy. Eur J Orthop Surg Traumatol 16, 207–209 (2006). https://doi.org/10.1007/s00590-005-0059-7
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DOI: https://doi.org/10.1007/s00590-005-0059-7