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Minimally Invasive Far Lateral Lumbar Discectomy With Modified Technique: Symptomatic Relief and Intersegmental Stability Study – Lumbar Spinal Stenosis

The article evaluates a modified minimally invasive surgery (MIS) technique for far lateral lumbar discectomy (FLDH) to reduce the need for bony drilling and minimize postoperative pain while lowering the risk of spinal instability. FLDH accounts for about 10% of all lumbar disc herniations and typically involves extra-foraminal nerve root compression. A retrospective review of 48 patients who underwent the modified technique showed promising results, with 93.5% experiencing symptom improvement and 58.7% achieving complete resolution in an average of 2.6 months. The study concludes that the modified technique provides MIS access to the extra-foraminal site of nerve root compression without bony drilling and maintains symptom resolution without sacrificing outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most established treatment facility in London

Published article

CONCLUSIONS: Our modified technique for FLLD allows MIS access to the extra-foraminal site of nerve root compression without the need for bony drilling. This minimizes postoperative pain and reduces the risk of iatrogenic spinal instability without sacrificing symptom resolution.

Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Cureus. 2024 Feb 1;16(2):e53415. doi: 10.7759/cureus.53415. eCollection 2024 Feb.ABSTRACTOBJECTIVE: To evaluate the use of a modified minimally invasive surgery (MIS) technique for far lateral lumbar discectomy (FLDH) that minimizes the degree of bony drilling required for nerve root decompression, increasing postoperative pain reduction rate with reduced risk of iatrogenic spinal instability.SUMMARY OF BACKGROUND DATA: FLDH,

Cureus. 2024 Feb 1;16(2):e53415. doi: 10.7759/cureus.53415. eCollection 2024 Feb.

ABSTRACT

OBJECTIVE: To evaluate the use of a modified minimally invasive surgery (MIS) technique for far lateral lumbar discectomy (FLDH) that minimizes the degree of bony drilling required for nerve root decompression, increasing postoperative pain reduction rate with reduced risk of iatrogenic spinal instability.

SUMMARY OF BACKGROUND DATA: FLDH accounts for approximately 10% of all lumbar disc herniations and is increasingly recognized in the era of advanced imaging techniques. These disc herniations typically result in extra-foraminal nerve root compression. Minimally invasive spine techniques are increasingly performed with various degrees of foraminal and facet removal to decompress the affected nerve root.

METHODS: The study design involves a single institutional, retrospective cohort technical review. The review was completed of all patients undergoing MIS far lateral lumbar discectomy between 2010 and 2020. Cross-sectional, summary statistics were calculated for all variables. Counts and percentages were recorded for categorical variables and mean and standard deviations were calculated for continuous variables.

RESULTS: A total of 48 patients underwent MIS far lateral lumbar discectomies (FLLD) from 2010 to 2020. The mean age was 63 ± 11.5 years (60.4% males), the mean BMI was 28.5 ± 5.5, and 20.8% smokers. The most common presenting complaint was both low back and radicular pain (79.2%) with 8.3% of patients suffering from motor weakness preoperatively. The mean follow-up time was 4.3 ± 2.7. The mean length of stay was 1.3 ± 1.4 days with 77.1% of patients discharged postoperative day one. Forty-three patients (93.5%) had improvement in their symptoms. Twenty-seven (58.7%) had complete resolution in 2.6 months on average. Six patients (13%) had immediate symptom resolution postoperatively.

CONCLUSIONS: Our modified technique for FLLD allows MIS access to the extra-foraminal site of nerve root compression without the need for bony drilling. This minimizes postoperative pain and reduces the risk of iatrogenic spinal instability without sacrificing symptom resolution.

PMID:38435187 | PMC:PMC10908426 | DOI:10.7759/cureus.53415

The London Spine Unit : most established treatment facility in London

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Minimally Invasive Far Lateral Lumbar Discectomy With Modified Technique: Symptomatic Relief and Intersegmental Stability Study

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Cureus. 2024 Feb 1;16(2):e53415. doi: 10.7759/cureus.53415. eCollection 2024 Feb.ABSTRACTOBJECTIVE: To evaluate the use of a modified minimally invasive surgery (MIS) technique for far lateral lumbar discectomy (FLDH) that minimizes the degree of bony drilling required for nerve root decompression, increasing postoperative pain reduction rate with reduced risk of iatrogenic spinal instability.SUMMARY OF BACKGROUND DATA: FLDH

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