Surgical techniques for far lateral lumbar disc herniations

Abstract

For extra-foraminal localization, the surgical technique of lumbar far lateral disc herniations are distinct from those situated medial to the facet joint. In this study the extra-foraminal space was approached by a posterior route by means of median or paramedian incisions and a posterolateral route with muscle splitting method on 5 cadaveric spine models. Posterior approach, though it is familiar to neurosurgeons and enables the classical interlaminary enterings, can be quite troublesome in case of facet joint hypertrophy. The posterolateral approach though wide enough, is too deep to work on and medially retracted musculature hampers the work from medial aspect of the facet joint. The purpose of this article is to acquaint the reader with the anatomy and the surgical techniques available to treat for extra-foraminal lumbar disc herniations.