Transdural Approach in Difficult Giant Disc Herniation Cases

Background: Massive central lumbar disc herniations can pose a significant operative challenge. A protruding disc can be approached either through the axilla of the cord or transdurally. Aim of Study: This study aimed to study the outcome of transdural approach in a massive disc prolapse causing cauda equina syndrome. MATERIALS AND METHODS: Of all the cases of disc prolapse, only patients presenting with massive disc protrusion/cauda equina syndrome were selected for the transdural approach. Seven males and three females in the age group of 40–60 years were treated by this method. Results: The transdural approach in a cauda equina patient was remarkably safe, short duration, and satisfactory results. Conclusion: Paraspinal approach through the axilla was superior for disc prolapse were exiting nerve root compression was present. For a fully blown cauda equina syndrome, the trandsural approach was easy, safe, and satisfactory.