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Parsectomy

  • Rand Voorhies
  • Gabriel Tender
  • Clifford Crutcher
  • Anthony Digiorgio
Chapter

Abstract

Lumbar tubular parsectomy is an approach similar to the microdiscectomy, which can be applied to any lumbar or even thoracic level. The parsectomy can be employed when the entire length of a specific spinal nerve needs to be decompressed. If only the pars interarticularis is removed, the corresponding lamina remains anchored to the inferior facet and its joint, and therefore the level is not destabilized.

Supplementary material

Video 4.1

Right L5 parsectomy. This patient had an EMG-confirmed L5 radiculopathy and a foraminal and extraforaminal right-sided disc herniation. The parsectomy was started laterally and continued medially until the origin of the L5 spinal nerve was exposed and decompressed. The foraminal and extraforaminal disc herniations were removed. The decompression of the entire length of the L5 nerve was confirmed (MP4 342692 kb)

References

  1. 1.
    Kogias E, et al. Incidental durotomy in open vs. tubular revision microdiscectomy: a retrospective controlled study on incidence, management and outcome. Clin Spine Surg. 2016.  https://doi.org/10.1097/bsd.0000000000000279.
  2. 2.
    Di Lorenzo N, et al. Pars interarticularis fenestration in the treatment of foraminal lumbar disc herniation: a further surgical approach. Neurosurgery. 1998;42:87–9; discussion 89-90.CrossRefPubMedGoogle Scholar
  3. 3.
    Tender GC, Baratta RV, Voorhies RM. Unilateral removal of pars interarticularis. J Neurosurg Spine. 2005;2:279–88.  https://doi.org/10.3171/spi.2005.2.3.0279.CrossRefPubMedGoogle Scholar
  4. 4.
    Tender GC, Kutz S, Baratta R, Voorhies RM. Unilateral progressive alterations in the lumbar spine: a biomechanical study. J Neurosurg Spine. 2005;2:298–302.  https://doi.org/10.3171/spi.2005.2.3.0298.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Rand Voorhies
    • 1
  • Gabriel Tender
    • 2
  • Clifford Crutcher
    • 3
  • Anthony Digiorgio
    • 3
  1. 1.Southern Brain and SpineMetairieUSA
  2. 2.Louisiana State UniversityNew OrleansUSA
  3. 3.Department of NeurosurgeryLouisiana State University Health Sciences CenterNew OrleansUSA

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