Para-muscular and trans-muscular approaches to the lumbar inter-vertebral foramen: an anatomical comparison

Arquivos de Neuro-Psiquiatria

Arthur Werner Poetscher²  Guilherme Carvalhal Ribas¹  Alexandre Yasuda¹  Koshiro Nishikuni¹ 

[1] ,Univerisdade de São Paulo Faculadade de Medicina Hospital das ClinicasSão Paulo SP ,Brazil

关键词: intervertebral disc displacement;    low back pain;    lumbar vertebrae;    sciatica;    comparative study;    deslocamento do disco intervertebral;    dor lombar;    vértebras lombares;    ciática;    estudo comparativo;   

DOI  :  10.1590/S0004-282X2005000100009

来源: SciELO

【 摘 要 】

Foraminal and extra-foraminal disc herniations comprise up to 11.7% of all lumbar disc herniations. Facetectomy, which had been the classic approach, is now recognized as cause of pain and instability after surgery. Otherwise, posterior lateral approaches through a trans-muscular or a para-muscular technique offer no significant damage to key structures for spinal stability. The surgical anatomy of these approaches has already been described, but they were not compared. In order to quantify the angle of vision towards the intervertebral foramen offered by each technique, 12 fresh cadavers were dissected and studied regarding these approaches. The angle presented by trans-muscular approach was wider in all studied lumbar levels. Surgery through the trans-muscular approach is performed with a better working angle, requiring a smaller resection of surrounding tissues. Therefore, minor surgical trauma can be expected. Our measurements support previously published data that point the trans-muscular approach as the best surgical option.

【 授权许可】

CC BY   
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