Dr Adriaan Liebenberg My Spine Lumbar | Page 114

Image used with permission from Medtronic Figure 18.1 The top illustration demonstrates the incision that is used for a microdiscec- tomy. Many specialists use an incision that is only about one third as long as the incision on the illustration. The length of the cut is of little consequence. Microdiscectomy is a relatively minor invasive procedure with the minimum amount of tissue damage. The illustration on the opposite page (top left) demonstrates the area through which the spinal canal is entered (circles), by taking a small amount of the lamina (see the chapter Anatomy of the Spine) and removing the ligament inside the spinal canal (ligamentum flavum). The picture on the opposite page (top right) reveals the nerves after the bit of the lamina and the ligamentum flavum has been removed. This image demonstrates the approach when both sides are done at the same time. Only one side would frequently be performed, especially if the disc herniation is only towards one side. The bottom two pic- tures (opposite page) demonstrate how the nerves are retracted to one side and the offending part of the disc removed. 114