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Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level Research Article

The London Spine Unit : innovative treatment hospital in London

Published article

CONCLUSION: The contralateral interlaminar approach is more suitable for all types of intra/extraforaminal disc herniations at the L5/S1 level. The most specific benefit of this approach is its avoidance of disruption/significant removal (i.e.,
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Surg Neurol Int. 2022 Jun 10;13:243. doi: 10.25259/SNI_400_2022. eCollection 2022.

ABSTRACT

BACKGROUND: Minimally invasive approaches to intra/extraforaminal lumbar disc herniations offer the benefit of less bone removal and reduced nerve root manipulation at the L5-S1 level. Moreover, the potential to better preserve stability.

METHODS: Here, we summarized the efficacy of the contralateral approach to intraforaminal/extraforaminal lumbar disc herniations particularly focusing on the L5-S1 level. Variables studied included the level of these disc herniations, their locations within the foramina, and the anatomy of the facet joints.

RESULTS: A major “pro” for the contralateral interlaminar procedure at the L5-S1 level is that it does not require facet joint removal, or with a spondylotic facet, <30% joint excision, to directly visualize the intraforaminal/ extraforaminal nerve root. It, therefore, reduces the risk of creating iatrogenic instability, while offering a higher certitude of adequate nerve root visualization, decompression, and safer disc removal.

CONCLUSION: The contralateral interlaminar approach is more suitable for all types of intra/extraforaminal disc herniations at the L5/S1 level. The most specific benefit of this approach is its avoidance of disruption/significant removal (i.e., <30%) of the facet joint to adequately expose the foraminal L5 nerve root, and more safely remove the intra/extraforaminal disc herniation.

PMID:35855125 | PMC:PMC9282753 | DOI:10.25259/SNI_400_2022

The London Spine Unit : innovative treatment hospital in London

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Pros of the contralateral (over-the-top) approach to intra/extraforaminal lumbar disc herniations at the L5-S1 level

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Surg Neurol Int. 2022 Jun 10;13:243. doi: 10.25259/SNI_400_2022. eCollection 2022.ABSTRACTBACKGROUND: Minimally invasive approaches to intra/extraforaminal lumbar disc herniations offer the benefit of less bone removal and reduced nerve root manipulation at the L5-S1 level. Moreover, the potential to better preserve stability.METHODS: Here, we summarized the efficacy of the contralateral approach to intraforaminal/extraforaminal lumbar disc herniations…
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