THE MODIFIED WILTSE APPROACH FOR TREATMENT OF EXTRAFORAMINAL DISC HERNIATION IN THE LUMBAR SPINE
https://doi.org/10.14531/ss2016.2.62-67
Abstract
Objective. To evaluate the effectiveness of a modified Wiltse approach to the lumbar spine for extraforaminal disk herniation.
Material and Methods. A total of 1020 patients with herniated lumbar intervertebral disc were operated on, out of them 30 (2.9 %) patients were diagnosed as having extraforaminal disc herniations most often observed at the L4-L5 (53.3 %) and L5-S1 (40.0 %) levels. Clinical manifestations included back pain in 20 patients (66.6 %) and radicular syndrome - in all patients, which was accompanied by movement disorders in 15 (50.0 %) cases and by sensitivity disorders in 9 (30 %). Evaluation of surgical results was performed in the early postoperative period and at 3 and 6 months after surgery. Clinical outcomes were assessed using modified MacNab criteria.
Results. Based on MacNab criteria, an excellent outcome was observed in 45 %, good - in 42 %, and satisfactory - in 13 % of cases at 6 months after surgery. The volume of intraoperative blood loss was on average 52.8 ± 30 mL, the average length of hospital stay was 2.6 days.
Conclusion. The modified Wiltse approach is an effective surgery to remove extraforaminal herniation in the lumbar spine, which allows achieving excellent and good results of treatment in 87 % of cases.
About the Authors
Vladimir Sergeyevich Klimov
Federal Center of Neurosurgery
Russian Federation
Russian Federation
Aleksey Vladimirovich Evsyukov
Federal Center of Neurosurgery
Russian Federation
Russian Federation
Murodzhon Azamovich Kosimshoev
Federal Center of Neurosurgery
Russian Federation
Russian Federation
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Review
For citations:
Klimov V.S., Evsyukov A.V., Kosimshoev M.A. THE MODIFIED WILTSE APPROACH FOR TREATMENT OF EXTRAFORAMINAL DISC HERNIATION IN THE LUMBAR SPINE. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2016;13(2):62-67. https://doi.org/10.14531/ss2016.2.62-67
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