Far Lateral Tubular Microdiscectomy for Extraforaminal, Foraminal, and Lateral Recess Acute Disc Herniation: Surgical Technique.

Abstract

We present a 7-minute stepwise instructional video alongside a detailed technical report defining our surgical approach. We outline our technique for tubular far lateral microdiscectomy for the treatment of a soft extraforaminal, foraminal, and lateral recess disc herniation, avoiding the need for spinal fusion. This technique relies on a suitable soft disc consistency. We demonstrate this with a case of a 50-year-old woman presenting with 1 month of acute onset L3 radiculopathy and weakness that is refractory to a cortisone block. Our step-by-step guide, presented in both video and written format, illustrates a specific situation where this technique may be applicable. The patient presented in this case was discharged home the following day, achieved full symptom resolution, and return of normal power/mobility, with sustained clinical outcome at 6 weeks follow-up. The careful preoperative consideration of patients to select a suitable disc consistency allows the effective implementation of this technique to achieve excellent outcomes and avoid spinal fusion.