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62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

07. - 11. Mai 2011, Hamburg

The intraforaminal approach to the nerve root via limited removal of the pars interarticularis – Report of 175 cases

Meeting Abstract

Suche in Medline nach

  • J. Schröder - ZW-O Zentrum für Wirbelsäulenchirurgie, Osnabrück
  • M. Winking - ZW-O Zentrum für Wirbelsäulenchirurgie, Osnabrück
  • A.G. Hellwig - ZW-O Zentrum für Wirbelsäulenchirurgie, Osnabrück

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocDI.02.01

DOI: 10.3205/11dgnc106, URN: urn:nbn:de:0183-11dgnc1064

Veröffentlicht: 28. April 2011

© 2011 Schröder et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To access intraforaminal pathology Tender described in 2005 his approach to the intraforaminal part of the nerve root via limited removal of the pars interarticularis. The approach allows control over the entire intra- and extraforaminal nerve root and ganglion, the effective enlargement of bony narrowing of the foramen and removal of hard and soft disk material.

Methods: We report our experience with a prospective series of 175 patients treated with this technique, 109 male 66 female, mean age at time of the procedure 57 ± 13 years (range 85 - 29 years) with a mean BMI of 27 ± 4 (range 40 - 19). The localisation was L2/3 in 8, L3/4 in 32, L4/5 in 79 and L5/S1 in 56 cases respectively, 102 were left, 72 right sided and one case bilateral. The procedure was performed under surgical microscope; the access to the nerve root was facilitated with a high-speed drill. The mean duration of the procedure was 36 ± 13 min (range 84 - 15 min). The patients were physically examined pre-, postoperatively and after 6 weeks and completed an Oswestry questionnaire and a visual analogue scale for leg and back pain.

Results: The Oswestry score (worst score 100 best score 0) dropped from 50 ± 20 preoperatively (range 98 - 4) to 28 ± 21 (range 80 - 0) postoperatively and 21 ± 18 (range 78 - 0) after 6 weeks. The visual analogue score for the back VAS-B (worst score 10 best score 0) dropped from 4.6 ± 2.9 preoperatively (range 10 - 0) to 2.4 ± 2.2 (range 9 - 0) postoperatively and 2.2 ± 2.1 (range 8 - 0) after 6 weeks. The visual analogue score for the leg VAS-L dropped from 6.8 ± 2.5 preoperatively (range 10 - 0.6) to 2.1 ± 2.3 (range 8 - 0) postoperatively and 2.0 ± 2.3 (range 10 - 0) after 6 weeks. No revision surgery has been performed up to now.

Conclusions: The Tender approach is an effective tool for the treatment of intraforaminal pathology from intraforaminal disk herniation to forminal stenosis, without destabilisation of the segment. The procedure is quick, safe and does not require any special equipment.