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

Abstract

Technical note. To show that approaching the lateral lumbar disc from the contralateral interlaminar space offers a wider exposure with reduced facet removal. 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. 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. 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. 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.