ArticleInternational journal of spine surgery2026
"ULTRA" Lateral Decompression Technique for Lumbar Discectomy: An Evaluation of 30-Day Outcomes From an 8-Year Single Surgeon Experience.
Article in International journal of spine surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTraditional midline microdiscectomy risks paraspinal muscle devascularization/denervation, particularly of the multifidus. We evaluated a standardized lateral-to-spinous Wiltse-interval tubular microdiscectomy (ULTRA, fixed 10-mm tube) designed to minimize muscle injury while maintaining microscopic control. We report 30-day safety and early functional outcomes from an 8-year, single-surgeon series.
methodsWe performed a retrospective analysis of a prospectively maintained, single-center registry of consecutive single-level lumbar discectomies (L2-L3 to L5-S1) undertaken from January 2017 to May 2024 using a fixed 10-mm tubular retractor through the lateral-to-spinous Wiltse corridor under microscopy. Primary endpoints were 30-day complications, readmissions, and reoperations; secondary endpoints included operative time, length of stay, same-day discharge, and change in Oswestry Disability Index (ODI). The study was Institutional Review Board approved, and consent was waived.
resultsA total of 973 procedures were analyzed (mean age 49 ± 12 years; 54.5% men; body mass index ≥30 kg/m² in 24.2%; 29.6% smokers; 6.8% diabetes). Mean operative time was 18 ± 5 minutes; 96.3% finished in <30 minutes. Same-day discharge occurred in 99.8% (971/973). Intraoperative dural tear occurred in 7.3% (71/973) and was primarily repaired; postoperative cerebrospinal fluid fistula occurred in 0.7% (7/973). No surgical site infections or epidural hematomas were observed. The 30-day readmission rate was 0.7% (7/973), and reoperation for recurrent herniation was 0.3% (3/973). Mean ODI improved from 74 ± 9 preoperatively to 18 ± 7 at 30 days (Δ56,
conclusionsA 10-mm lateral-to-spinous (Wiltse) tubular approach enables rapid decompression with low early morbidity and large early functional gains. Properly repaired intraoperative dural tears did not worsen short-term outcomes. CLINICAL RELEVANCE: Findings support routine outpatient use of a 10-mm Wiltse corridor for lumbar disc herniation and provide benchmark 30-day rates for counseling and quality assurance. LEVEL OF EVIDENCE: 4:
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