Ligament-sparing lumbar microdiscectomy: Technical note

Abstract

BACKGROUND The prevention or inhibition of postoperative adhesions is a significant goal for successful lumbar discectomy, not only to reduce the probable risk of recurrent radiculopathy, but also to improve the likelihood of success of Pe-operation. METHODS We describe a new technique for sparing the ligamentum flavum in lumbar microdiscectomy. The superficial layer of the ligament is removed by horizontal splitting. Additional horizontal splitting of the ligament yields a paperthin deep layer. Lateral vertical splitting and retraction is then carried out to provide a sufficient operative window. The split ligament returns to its original position after releasing the retraction, thereby closing the operative window. RESULTS This method could preserve a layer of the ligamentum flavum to act as a physical barrier, which in turn greatly restricts the peridural fibrosis. CONCLUSIONS This ligament-sparing technique enables surgeons to preserve the original anatomic plane and to reduce the extent of postoperative adhesion. (C) 2000 by Elsevier Science Inc.