Giant central lumbar disc herniations: a case for the transdural approach

Annals of the Royal College of Surgeons of England
I Tulloch, M C Papadopoulos

Abstract

Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscectomy technique. This is the first report to date of a giant central L3/4 disc protrusion being successfully treated through a transdural microdiscectomy approach. Prior to this report, there have been just two cases describing its application in the lumbar spine. However, neither of these reports has described its use below the level of L2/3. We compare our surgical technique with these authors and discuss the pros and cons of this surgical approach relative to the standard extradural microdiscectomy technique. Overall, we have observed encouraging results from this approach and this report would support a role for further investigation into this rarely used technique.

References

Sep 20, 2007·Journal of Neurosurgery. Spine·Jeong-Wook ChoiSoo-Han Kim
Feb 10, 2010·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Sung-Jun MoonSoo-Han Kim
Sep 22, 2010·Journal of Korean Neurosurgical Society·Duk-Sung KimSoo-Han Kim
Feb 20, 2014·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Wojciech KonczalikBronek Boszczyk

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