Background: To present our Tubular minimally invasive approach for foraminal and extraforaminal disc herniation, AKA known as far lateral disc herniation using the Medtronic MetRx tubular system along with a surgical microscopic and to report our clinical results. Aim of the Work: Our study aims to evaluate patients that underwent MIS FLD herniation surgery with the tubular retractors in terms of clinical improvement, intraoperative blood loss, operative time, complications and post operative hospital stay. Patients and Methods: Retrospective analysis of data collected from our case series of patients that underwent minimally invasive tubular discectomy for far lateral disc herniation in the period from 2/2018 to 9/2021 We assessed pre and post VAS for leg pain, neurological status and complications.
Results: The study included 23 patients; the mean follow up time was months. Motor weakness improved in 75 % of patients that had weakness pre operatively. Sensory deficits improved in 62.5% of patients. The mean VAS for leg pain showed marked improvement from 8.5 before surgery to 2 after surgery (P value <.01). Complications included one patient with CSF leakage that was intraoperatively with fat graft and surgical glue on top, there was no CSF leakage in the post operative course. Conclusion: Our results propose that MIS tubular discectomy for far lateral disc herniation is safe, efficient and might be a good alternative for open approaches.