Abstract
Introduction
The purpose of this study is to show the good results, we can obtain by making hemilaminectomy with foraminotomy and discectomy for herniated lumbar disc disease. Lumbar disc disease is a common affliction. Surgical intervention provides excellent results in carefully selected patients. Discectomy with hemilaminoforaminotomy through a small incision with surgery loupes or microscope permits an accurate decompression of the root with results from good to excellent.
Methods
The surgical records of 445 patients, who underwent surgical intervention for herniated lumbar disc disease in an 18.5-year period between March 1996 and September 2014, were checked. A total 202 were women and 243 men. The range age was 14 to 83 years with an average of 48.5 years. All the patients had root pain in a dermatome pattern because of herniated lumbar disc disease with or without foramen stenosis and they were evaluated with imaging studies as: MRI and some of them with CT. Patients older than 60 years (128 patients) had foramen stenosis and they had the same procedure. They were treated with hemilaminoforaminotomy and discectomy through a small incision: 236 patients were operated on one level, 169 were operated on two levels and the other 40 patients were underwent more than two levels. The outcome results were collected at a range from 2 months to 18 years. Over 293 patients have a 10-year follow-up. The procedure was hemilaminectomy with foraminotomy and discectomy using microscope or surgery loupes. Hospitalization was from 12 to 24 hours.
Results
The results were defined according to Macnab scale as excellent 84, good 10, regular 4, and poor 2% (Fig. 1).
Conclusion
The results of these series indicate that most patients do well after hemilaminoforaminotomy with discectomy and root decompression. It is safe and it does not have destabilization risk. With this procedure, the outcomes are from good to excellent, although the patients had to be well selected by examination and radiological findings. This kind of minimal invasion surgery allows patients to have a fast recovery with low cost, it enables a quick reincorporate to work and esthetically pleasant.
