Depth-labeled lumbar disc forceps for safe lumbar disc surgery: Our experience with 405 patients

Abstract

Injury of intraabdominal structures by rupturing the anterior longitudinal ligament is a known complication of discectomy. Despite its very low incidence, it has a high mortality. Although various minimally invasive methods are defined for discectomy, no significant reduction in this complication has been achieved. Positioning of the patient, aggressive discectomy, and deep-seated use of disc forceps are important risk factors. The aim of this study is to share our experience with modified instruments to minimize the risk of vascular and visceral injury during discectomy in surgically treated 405 patients with lumbar disc herniation. We routinely perform preoperative depth measurements at the level of lumbar disc herniations for the patients undergoing lumbar disc surgery and check the neighborhood with the prevertebral structures. During the operation, we perform discectomy with custom disc forceps that were labeled with centimeter measurements in accordance with these lengths. We performed discectomy on 405 patients using these forceps between January 2015 and May 2021. In this retrospective study, disc depth measurements differed according to disc levels and gender. Disc depth was longer in males at all lumbar disc levels. It is very important to avoid vascular and visceral injuries for spinal surgeons. For this reason, we believe that knowing the safe preoperative discectomy depth and area and using centimeter-labeled disc forceps is the best method to prevent such complications. © 2022 Ondokuz Mayis Universitesi. All rights reserved.