Interlaminar approach for excision of lateral lumbar disc herniation: technical note.

ABSTRACT

STUDY DESIGN: Technical note. OBJECTIVE: To show that approaching the lateral lumbar disc from the contralateral interlaminar space offers a wider exposure with reduced facet removal. SUMMARY OF BACKGROUND DATA The interlaminar approach is a well-established approach for the removal of lateral lumbar disc herniation (LLDH). However, access to the lateral disc space via this approach may be difficult and requires generous facet joint removal. METHODS: A 41-year-old woman presented with a 2-year history of low back pain and severe left leg pain. Computerized tomography of the lumbar spine revealed a left-sided intraforaminal lateral disc protrusion at L4/5 level. RESULTS: The patient underwent a left L4/5 discectomy and removal of the lateral disc via the interlaminar approach from the contralateral (right) side with excellent postoperative result. CONCLUSIONS: The authors present a modification of the interlaminar microsurgical approach for excision of an intraforaminal lateral disc herniation in which the herniated disc is approached from the contralateral interlaminar space through a midline incision. The facet joint removal is less, and the exposure is superior to the traditional interlaminar approach.