Skip to main content

Translaminar approach to cranio-laterally herniated lumbar disc prolapse

Abstract

Background

For cranio-laterally extruded disc fragments, a far enlargement of the standard interlaminar fenestration is necessary. This strategy harbours a potential risk for relevant destruction of the facet joints and postsurgical instability could be the consequence. For preserving the facet joint, a limited approach through the hemilamina is possible.

Method

After the standard paramedian soft tissue approach and retraction of the paravertebral muscles laterally, the hemilamina is exposed and fenestrated, preserving the bony borders of the lamina. The disc herniation can be extracted via this lamina fenestration.

Conclusion

This surgical strategy is safe and effective in approaching cranially herniated disc fragments.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Bernucci C, Giovanelli M (2007) Translaminar microsurgical approach for lumbar herniated nucleus pulposus (HNP) in the “hidden zone”: clinical and radiologic results in a series of 24 patients. Spine (Phila Pa 1976) 32(2):281–284

    Article  Google Scholar 

  2. Di Lorenzo N, Porta F, Onnis G, Cannas A, Arbau G, Maleci A (1998) Pars interarticularis fenestration in the treatment of foraminal lumbar disc herniation: a further surgical approach. Neurosurgery 42:87–90

    PubMed  Article  Google Scholar 

  3. Garrido E, Connaughton PN (1991) Unilateral facetectomy approach for lateral lumbar disc herniation. J Neurosurg 74:754–756

    PubMed  Article  CAS  Google Scholar 

  4. Hassler W, Brandner S, Slansky I (1996) Microsurgical management of lateral disc herniations: combined lateral and interlaminar approach. Acta Neurochir (Wien) 138(8):907–910

    Article  CAS  Google Scholar 

  5. Papavero L, Langer N, Fritzsche E, Emami P, Westphal M, Kothe R (2008) The translaminar approach to lumbar disc herniations impinging the exiting root. Neurosurgery 62(3 Suppl 1):173–177

    PubMed  Article  Google Scholar 

  6. Reulen HJ, Müller A, Ebeling U (1996) Microsurgical anatomy of the lateral approach to extraforaminal lumbar disc herniations. Neurosurgery 39:345–350

    PubMed  Article  CAS  Google Scholar 

  7. Seiz M, Pechlivanis I, Bag S, Schmieder K, Thome C, Tuettenberg J (2009) Translaminar fenestration for caudally herniated lumbar discs—a technical note. Z Orthop Unfall 147(5):597–599

    PubMed  Article  CAS  Google Scholar 

  8. Soldner F, Hoelper BM, Wallenfang T, Behr R (2002) The translaminar approach to canalicular and cranio-dorsolateral lumbar disc herniations. Acta Neurochir (Wien) 144(4):315–320

    Article  CAS  Google Scholar 

  9. Tessitore E, de Tribolet N (2004) Far-lateral lumbar disc herniation: the microsurgical transmuscular approach. Neurosurgery 54(4):939–942

    PubMed  Article  Google Scholar 

  10. Vogelsang JP (2007) The translaminar approach in combination with a tubular retractor system for the treatment of far cranio-laterally and foraminally extruded lumbar disc herniations. Zentralbl Neurochir 68(1):24–28

    PubMed  Article  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. Schulz.

Electronic supplementary material

Below is the link to the electronic supplementary material.

(MOV 109724 kb)

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Schulz, C., Abdeltawab, A. & Mauer, U.M. Translaminar approach to cranio-laterally herniated lumbar disc prolapse. Acta Neurochir 154, 711–714 (2012). https://doi.org/10.1007/s00701-012-1300-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-012-1300-x

Keywords

  • Lumbar spine
  • Disc herniation
  • Translaminar sequestrectomy