Anatomic and morphologic substantiation of techniame of microsurgical access in excision of hernia of lumbar intervertebral diskc

Abstract

On the basis of morphological research the substantiation of use of medial fasetectomy is yielded at microsurgical of lumbar disk herniations. Out of 530 cases of microdiskectomy medial fasetectomy was performed in 382 cases (72 %): at level L3-L4 in 30 cases (100 %), at level L4-L5 in 206 cases (91 %), at a level L5-S1 in 145 cases (53 %). The data on frequency of use of medial fasetectomy in operations on lumbar disk herniations correspond to the features, revealed by us, of a topographical constitution of the nerve root canal on each level. Use of medial fasetectomy in microdiscectomy allows one to reduce the trauma of neurovascular formations, to reduce to a minimum possible neurologic complications, it yields good opportunities for high-grade revision of the disc space, which allows one to reduce the percentage of recurrent disk herniations.