A Retrospective Study of Far Lateral Midline Microlumbar Discectomy in 20 Patients at a Single Center in Turkey.

Serdal Albayrak, İbrahim Burak Atcı
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Abstract

BACKGROUND Microdiscectomy is a minimally-invasive surgical technique for treating far lateral lumbar disc herniation (FLLDH). This retrospective study from a single center in Turkey aimed to evaluate midlinelumbar discectomy in 20 patients with far lateral lumbar disc herniation. MATERIAL AND METHODS We collected clinical data of 20 patients (11 men, 9 women) operated for FLDDH between January 2006 and January 2022. Patients' age, sex, surgical level, examination findings, motor deficit, duration of operation, complications during the operation and preoperative/postoperative 6 month visual analogue Scala (VAS), preoperative/postoperative 6th month Oswestry Disability Index (ODI) scores were evaluated. RESULTS The patients were 11 men (55%) and 9 women (45%), with a mean age of 52.08±11.21 years. The mean duration of symptoms before the operation was 3.4 weeks. Laseque sign positivity was found in 86.4% of the patients. Motor deficit was present in 30% of the patients. After 6-month follow-up, preoperative VAS value decreased from 9.35±0.75 to 0.84±0.75. Preoperative and postoperative VAS score averages were significantly different (P=0.0001). Operation ODI values were 73.63±3.76 before and after surgery, and decreased to 14.81±3.63 at 6 months. CONCLUSIONS The term distal lateral disc herniation was first defined in the literature in 1974 when the disc was seen in a different location than the normal location compared to the facet. Far lateral disc herniation can be operated on successfully with midline skin incision.

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土耳其单中心20例远外侧中线微腰椎间盘切除术回顾性研究。
背景:微椎间盘切除术是治疗远外侧腰椎间盘突出症的一种微创手术技术。这项来自土耳其单一中心的回顾性研究旨在评估20例远外侧腰椎间盘突出症患者的腰间线椎间盘切除术。材料和方法我们收集了2006年1月至2022年1月期间因FLDDH手术的20例患者(11男9女)的临床资料。评估患者的年龄、性别、手术级别、检查结果、运动缺陷、手术持续时间、手术并发症及术前/术后6个月视觉模拟Scala (VAS)、术前/术后6个月Oswestry残疾指数(ODI)评分。结果男性11例(55%),女性9例(45%),平均年龄52.08±11.21岁。术前平均症状持续时间为3.4周。Laseque征阳性占86.4%。30%的患者存在运动障碍。随访6个月后,术前VAS评分由9.35±0.75降至0.84±0.75。术前、术后VAS评分平均值差异有统计学意义(P=0.0001)。术前术后ODI值为73.63±3.76,6个月时为14.81±3.63。结论:1974年文献中首次定义了远侧椎间盘突出症,当时与关节突相比,椎间盘出现在不同的位置。远外侧椎间盘突出症采用中线皮肤切口可成功手术。
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