Minimally invasive tubular microdiscectomy - A 3-D operative video

Zachary A. Smith, Nader S. Dahdaleh, Albert P. Wong, Salah G. Aoun, Tarek Y. El Ahmadieh, Alexander T. Nixon, Bernard Bendok, Richard G. Fessler

Research output: Contribution to journalArticle

Abstract

Minimally invasive spine techniques have been developed with the goal of achieving the same outcomes of open surgery through smaller incisions and minimal muscle dissection. Paraspinal muscle dissection and devascularization is a cause of postoperative pain, wound infection, and prolonged hospitalization. It has been well documented that with minimally invasive tubular access surgery, muscle stripping is obviated, resulting in faster patient recovery, and decreased complication rates (CSF leaks and wound infections) while maintaining similar long-term outcomes compared to open techniques.In this video, we describe a common application of tubular surgery: minimally invasive discectomy, demonstrated in a 3-dimensional video. A 47 year old female whose BMI was 45.7 presented with right lower extremity radiculopathy with radiating pain along the L5 dermatome. She also had weakness with dorsiflexion. She was evaluated with an MRI that showed a large right-sided paracentral disk herniation at the L4/5 level. Her symptoms progressed in spite of three months of conservative treatment. Therefore, she underwent a right-sided minimally invasive discectomy where a large disk fragment was resected. The patient had immediate relief of her symptoms and was discharged home the same operative day.This operative video also serves as an educational tool for residents interested in minimally-invasive spine surgery, where personal exposure with the technique is limited until they reach their more senior operative years.

Original languageEnglish (US)
JournalNeurosurgery
DOIs
StateAccepted/In press - Nov 27 2012
Externally publishedYes

Fingerprint

Diskectomy
Minimally Invasive Surgical Procedures
Dissection
Spine
Paraspinal Muscles
Surgical Wound Infection
Muscles
Radiculopathy
Wound Infection
Postoperative Pain
Lower Extremity
Hospitalization
Pain
Conservative Treatment

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Smith, Z. A., Dahdaleh, N. S., Wong, A. P., Aoun, S. G., El Ahmadieh, T. Y., Nixon, A. T., ... Fessler, R. G. (Accepted/In press). Minimally invasive tubular microdiscectomy - A 3-D operative video. Neurosurgery. https://doi.org/10.1227/NEU.0b013e31827e1691

Minimally invasive tubular microdiscectomy - A 3-D operative video. / Smith, Zachary A.; Dahdaleh, Nader S.; Wong, Albert P.; Aoun, Salah G.; El Ahmadieh, Tarek Y.; Nixon, Alexander T.; Bendok, Bernard; Fessler, Richard G.

In: Neurosurgery, 27.11.2012.

Research output: Contribution to journalArticle

Smith, ZA, Dahdaleh, NS, Wong, AP, Aoun, SG, El Ahmadieh, TY, Nixon, AT, Bendok, B & Fessler, RG 2012, 'Minimally invasive tubular microdiscectomy - A 3-D operative video', Neurosurgery. https://doi.org/10.1227/NEU.0b013e31827e1691
Smith ZA, Dahdaleh NS, Wong AP, Aoun SG, El Ahmadieh TY, Nixon AT et al. Minimally invasive tubular microdiscectomy - A 3-D operative video. Neurosurgery. 2012 Nov 27. https://doi.org/10.1227/NEU.0b013e31827e1691
Smith, Zachary A. ; Dahdaleh, Nader S. ; Wong, Albert P. ; Aoun, Salah G. ; El Ahmadieh, Tarek Y. ; Nixon, Alexander T. ; Bendok, Bernard ; Fessler, Richard G. / Minimally invasive tubular microdiscectomy - A 3-D operative video. In: Neurosurgery. 2012.
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