Far Lateral Disc Prolapse: Surgical Options in Limited Resources Centers

Abstract

Far lateral disc prolapse accounts for 6.5% to 12% of all lumbar disc prolapses. Surgical options include open laminectomy with discectomy, microscopic and endoscopic excision of the prolapsed disc. Some of these options may not be available in limited resources centers. We will highlight the effectiveness of various surgical options. Twenty patients with foraminal and extraforaminal lumbar disc prolapse were operated upon from January, 2015 to June, 2016 in the neurosurgical departments of Cairo and Fayoum Universities in Egypt by different modalities (open laminectomy with discectomy, microscopic and endoscopic discectomy). Seventeen patients had foraminal disc prolapse and only three patients had extraforaminal disc prolapse. Twelve patients were operated by conventional laminectomy approach. Microscope was used in four patients and four patients were operated endoscopically. Excellent radicular pain improvement was achieved in 15 cases (75%) including all of the laminectomy groups. Conventional laminectomy and discectomy in far lateral disc prolapse remains an excellent option especially in limited resources centers. Although building up experience with other surgical modalities is mandatory.