The transfacet pedicle-sparing approach for XXXX : cadaveric morphometric analysis and preliminary clinical experience.

@entity1 @entity1797 @entity190 @entity602 @entity1514 @entity3138 @entity158 @entity614 @entity890
A number of operative techniques have been described for the treatment of herniated @entity1514 . The transfacet pedicle-sparing approach allows for @entity1797 limited spinal column disruption and soft-tissue dissection. Fifteen cadaveric spinal columns were used for evaluation of exposure, development of thoracic microdiscectomy instrumentation, and establishment of morphometric measurements. This approach was used to remove eight @entity1514 in six @entity1 . Levels of herniation ranged from T-7 through @entity3138 . Preoperatively, all @entity1 had moderate to severe @entity158 , and three (50%) of the six had @entity158 . @entity602 was present in four (67%) of the six @entity1 . Through a 4-cm opening, the ipsilateral paraspinal muscles were reflected, and a partial facetectomy was performed. The disc was then removed using specially designed microscopic instrumentation. Postoperatively, the @entity614 resolved in all @entity1 . @entity158 and @entity602 were completely resolved or significantly improved in all @entity1 . The minimal amount of bone resection and muscle dissection involved in the operation allows for: 1) decreased operative time and @entity190 ; 2) diminished perioperative @entity158 ; 3) shorter hospitalization time and faster return to premorbid activity; 4) avoidance of closed chest tube drainage; and 5) preservation of the integrity of the facet-pedicle complex, with potential for improvement in outcome related to @entity158 . This technique appears best suited for the removal of all centrolateral discs, although it has been used successfully for treating a disc occupying nearly the entire ventral canal. The initial experience suggests that this approach may be used to safely remove appropriately selected @entity890 with good results.
