An oblique paraspinal approach for intracanalicular disc herniations of the upper lumbar spine: technical case report.

Abstract

To present our experience of treating the central or paramedian disc herniations of the upper lumbar levels through a paraspinal approach. We present four patients with intracanalicular disc herniations at the L1-L2 or L2-L3 level. All patients had unilateral or bilateral radicular leg pain and motor weakness. Considering the unique characteristics of the upper lumbar spine, we performed the oblique paraspinal approach to expose the central portion of disc and removed the herniated disc effectively. Postoperatively, their symptoms were improved. There was no instability during the follow-up period. The oblique paraspinal approach for the treatment of central disc herniations at the upper lumbar levels is an effective nonfusion technique that preserves most of the facet joint and provides a wide surgical field.