How to perform a lumbar discectomy?

Herniated disc syndrome in the lumbar spine is the consequence of the conflict between a spinal root or cauda equina and a fragment of nucleous polpous migrated trough the annulus fibrosus. The rapid compression of one or more spinal roots produces severe pain and or sensitive or motor deficits. Lumbar discectomy is usually indicate after 6-12 weeks of conservative treatment if pain remains intractable or in case of severe sensitive or motor deficits. The aim of this video is to show the lumbar discectomy of a 36 Y/O patients suffering from 12 weeks intractable low-back pain associated with right S1 root radiculopathy. 3 cm median skin incision is made from L5 to S1. Paravertebral muscles were detached from the right lamina of L5 and S1. A little laminectomy of right L5 lamina was peformed sparing the lateral articular process and the pars interarticularis. The ligamentum flavum is removed in the interlaminal space, to expose the dural sac and the S1 exiting root. The herniated fragment is identified and carefully removed; attention should be paid to extract the disc fragments in continuity to decreasing the risk of disc herniation fragmenting and leaving residual fragments inaccessible. The herniated disc syndrome in the lumbar spine can successfully treated by discectomy; the articular facet remains intact and the bone removal is little.