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| (L)L5/S1 Microlumbar discectomy: |
| Dr. A. Vincent Thamburaj, |
| Neurosurgeon, Apollo Hospitals, Chennai, India. |
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Clip1:
The patient is positioned prone; thru' a longitudinal incision, the paraspinal muscles are separated only on the ipsilateral side,and kept retracted with hemilaminectomy retracters; the interlaminar space is cleared off soft tissues. The interlaminar ligament and the ligamentum flavum are incised. |
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Clip2:
The interlaminar ligament and the ligamentum flavum are excised with precautions to avoid injury to the underlying dura. Up cutting punch is useful to clear the interlaminar space. The clearance is more towards superomedially.
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Clip3:
The bulging disc is visualized after retracting the nerve root; the disc is incised and the nucleus pulposus is being eased out. |
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Clip4: Disc excision continues with punch, and scoop; curved punch is helpful for thorough clearance. The space is probed for residual disc and the nerve root is found to be lax confirming adequate disc excision. |
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