الفهرس 
Title : Foraminal and far lateral lumbar disc herniations : surgical alernatives and their outcome
abstractOnly 14 pages are availabe for public view
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Abstract
Background: Far lateral disc herniation is also known as foraminal,
intraforaminal, far lateral or extreme lateral disc herniation, which by
definition refers to a disc herniation or fragment that resides beneath and
lateral to the vertebral facet. Patients with far lateral disc herniations usually
present by lower limb radicular pain rather than back pain or both.There has
been discussion as to the most suitable surgical approach to a far lateral disc
herniation. Some surgeons use an interlaminar approach, but full exposure of
the nerve root requires total resection of the facet joint which may lead to
subsequent instability of the spine. This has led to the development of
approaches to expose the nerve root within the intertransverse space by a
paramuscular route with retraction of the erector spinae from the midline, or
by muscle splitting, usually with a paramedian incision. These require
minimal resection of bone. The paramuscular route is preferred by many,
despite its disadvantages, because surgeons are not familiar with the anatomy
of the muscle-splitting approach. What we are concerned with here is to
compare which surgical aprroache is attain a better and more durable outcome
Objective: The aim of this study is to compare between the differnent surgical
approaches(medial facetectomy , full facetectomy and fusion,intertransverse )
in the management of single level far lateral lumbar disc herniation.
Methods: This is a prospective study done on 33 patients of far lateral disc
herniations divided into three groups (11 in each group) group (A) medial
facetectomy group ,group (B) full acetectomy and fusion group C paramedian
intertransverse in the period between October 2020 and August 2021 in
neurosurgery department at Cairo University Hospitals and fulfilling the
inclusion criteria. Diagnosis will be made clinically with history (low back
pain, sciatica, …). Examination (motor power, straight leg raising test,…) and
radiological findings in MRI, CT and X-ray of lumbo-sacral spine. The pain
status (VAS) will be pre- and postoperatively evaluated and followed up every
three months for one year