Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of Neurosurgery, Lindenhofspital, Bern, Switzerland.
J Neurol Surg A Cent Eur Neurosurg. 2022 Nov;83(6):511-515. doi: 10.1055/s-0041-1739221. Epub 2021 Dec 12.
Surgery for intra-/extraforaminal disk herniations (IEDH) is technically demanding due to the hidden location of the compressed nerve root section. Ipsilateral approaches (medial and lateral) are accompanied by extended resection of the facet joint and inadequate visualization of the pathology, especially at the L5-S1 level.
We describe a microsurgical interlaminar contralateral approach (MICA) suitable for IEDH at the lumbosacral junction that can also be used at L4-L5 and L3-L4.
The MICA provides access and sufficient intraforaminal visualization for IEDH in the lumbosacral region without resection of stability-relevant structures or manipulation of the nerve root ganglion.
由于受压神经根节段的位置隐蔽，椎间孔内外椎间盘突出症（IEDH）的手术技术要求较高。同侧入路（内侧和外侧）伴随着关节突关节的广泛切除和对病变的观察不足，尤其是在 L5-S1 水平。
我们描述了一种适用于腰骶部椎间孔内外椎间盘突出症的显微经椎间孔对侧入路（MICA），也可用于 L4-L5 和 L3-L4。
MICA 可提供进入和充分的椎间孔内可视化，用于腰骶部 IEDH，而无需切除稳定性相关结构或神经根节的操作。
