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Advances in Orthopedics
Volume 2014, Article ID 702163, 6 pages
http://dx.doi.org/10.1155/2014/702163
Clinical Study

Early Postoperative Results after Removal of Cranially Migrated Lumbar Disc Prolapse: Retrospective Comparison of Three Different Surgical Strategies

Department of Neurosurgery, German Federal Armed Forces Military Hospital, Oberer Eselsberg 40, 89081 Ulm, Germany

Received 14 August 2014; Revised 26 October 2014; Accepted 28 October 2014; Published 13 November 2014

Academic Editor: Panagiotis Korovessis

Copyright © 2014 C. Schulz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. To compare the early postoperative results of three surgical approaches to lumbar disc herniations that migrated cranially. Minimally invasive techniques such as the translaminar and endoscopic transforaminal approaches are utilized in patients with lumbar disc herniations to gain access to cranially located disc material and to avoid the potentially destabilizing resection of ligament and bone tissue, which is associated with an extended interlaminar approach. Methods. This retrospective study compares the postoperative pain and functional capacity levels of 69 patients who underwent an interlaminar (Group A, ), a translaminar (Group B, ), or an endoscopic transforaminal procedure (Group C, ). Results. Median VAS scores for leg pain decreased significantly from before to after surgery in all groups. Surgical revisions were required in thirteen cases (five in Group A, one in Group B, and seven in Group C; ). After six weeks, there were significant differences in back pain and functional outcome scores and in the results for the MacNab criteria but not in leg pain scores. Conclusions. The interlaminar and translaminar techniques were the safest and fastest ways of gaining access to cranially migrated disc material and the most effective approaches over a period of six weeks.