Clinical experience on intertransverse extraforaminal approach for far lateral disc herniations: 132 cases

Background: Far lateral disc herniations attract many spine surgeons for their type of onset, degree of pain, risk of neurological deficit, and increasing incidence. Today, a direct approach to the region by miminally invasive techniques is preferred. Aims: We aimed to present the results of the cases that were operated via intertransverse extraforaminal approach through a midline incision. Patients and Methods: One hundred thirty-two patients who were operated for far lateral disc herniation by extraforaminal approach between January 2010 and December 2017 were retrospectively evaluated. The demographical data, level of disc herniations, examination findings, preoperative and postoperative VAS scores, and postoperative long-term MacNab satisfaction rates were recorded. Results: Sixty-nine of the patients were male. The mean age was 58.1 years. Acute onset pain was a dominant complaint in 75% of the cases. The mean preoperative VAS score of 8.24 decreased to 2.08 at one month postoperatively. Based on a mean follow-up of 34.4 months, the long-term satisfaction rates according to Macnab criteria were 74% excellent-good, 20% moderate, and 6% poor. Conclusion: Intertransverse extraforaminal approach is an effective and safe technique for far lateral disc herniations. However, considering the anatomical restrictions and the unfamiliarity of the surgeons with the region, it is important that the surgeons perform the surgery with the technique they know best to increase the success of the surgery.