Microinvasive Bilateral Decompression Via Unilateral Surgical Approaches in The Bilateral Lumbar Disc Herniation (Contralateral Discectomy): A Novel Technique and Clinical Study
Journal Title: Journal of Neurological Sciences-Turkish - Year 2006, Vol 23, Issue 2
Abstract
Objective: Bilateral lumbar disc herniation is rare in the neurosurgical practices. Surgical approach in bilateral lumbar disc herniation is bilateral laminotomy and discectomy. This technique has disadvantages. Minimally invasive bilateral microdecompressive surgery (contralateral discectomy) is described by unilateral laminotomy (MIBMS) technique in this study and not reported before, but minimal invasive microdecompressive spinal canal decompression without contralateral discectomy has been reported in the lumbar spinal stenosis. Contralateral discectomy is a novel technigue. We now describe our clinical experience with this novel technique, minimally invasive bilateral microdiscectomy via unilateral laminotomy technique in the four patients. Methods: We prospectively four patients with lumbar bilateral disc herniation surgically treated with MIBMS. Short-term follow-up was available for 2 patients (7 weeks, 5 month) and long-term follow-up was available for 2 patients (2 year, 2.5 year ). Clinical outcome was determined by chart review and the use of a standardized questionnaire. All of pateints were operated by epidural anasthesia, for thus, preoperative and postoperative back and leg pain, ambulation, employment status, and satisfaction were assessed. Results: All of them were operated by this technique with successfully. No postoperative complications. Overall improvement postoperatively was noted in 94% of the bilateral lumbar disc herniations at mild and long-term follow-up. Average hospital stay day was 1 day, respectively. Visual analog scale (VAS) value was mean 2. Conclusion: We believe that MIBMS better preserves the spine's natural architecture and may contribute to improved postoperative contralateral osseoligamentousmuscle stability. As surgeons push for less radical or less invasive surgical techniques to obtain the same or better postoperative results, MIBMS is a good alternative to total laminectomy or bilateral hemipartially laminectomies. This new techniques was achieved under the midline, thereby preserving the supraspinous-interspinous ligaments and contralateral musculature. This technique is superior in bilateral pathologies.
Authors and Affiliations
Kadir KOTIL, Turgay BILGE
Keywords
Related Articles
- EP ID EP112970
- DOI -
- Views 98
- Downloads 0
Neuroleptic malignant-like syndrome due to herbicide intoxication
It is known that malignant neuroleptic syndrome (MNS) like symptoms occur with non-neuroleptic medication. But in the literature, there is only one case of MNS due to herbicide intoxication, called basagran. Our case was...
Erişkinlerde Dural İnvazyon Gösteren Kistik Meningiomlar
Kistik meningiomlar nadir görülen tümörlerdir. Bu tümörlerde belirgin bir histolojik tip baskınlığı görülmemiştir. Kistik meningiomlarda MRI ile %80 oranında doğru tanı konulabilmektedir. Bununla birlikte bazı olgularda...
İntravenöz Immunglobulin Tedavisi; Hematolojik ve Biyokimyasal Etkilenim
İntravenöz İmmünglobülin (IVIg) tedavisi pek çok nörolojik hastalıkta uygulanan bir immün modülatuvar tedavi olup, daha önce yapılan çalışmalarda inme ve miyokard enfarktüsü gibi tromboembolik olaylarla ilişkilendirilmiş...
Sudden Akathisia and Parkinsonism in a Uremic Patient
The authors report here a case of sudden developed severe akathisia and parkinsonism with basal ganglia lesions in a 52-years-old diabetic uremic patient. Magnetic resonance of brain showed hyperintensities on T1 weighte...
Endoscopic Neurosurgery and Endoscope-assisted Microneurosurgery For The Treatment of Space Occupying Lesions of The Septum Pellucidum
The application of endoscopes in neurosurgery has improved the succesfull and atraumatic operative treatment of deep-seated intraventricular lesions. Moreover, endoscope-assisted microsurgery provided a high rate of effi...