Bone Tunnel Repair of Traumatic Lumbar Hernias Without Mesh: A Multidisciplinary Case Series and Literature Review
Raju S, Vignaroli K, Malkoc A, Tadevosyan E, Tran A, Mohammed M, Carlson B, Lamore L, Elsissy J, Woodward B.
Abstract
Lumbar hernias are rare, comprising less than 1.5% of all hernias, with traumatic lumbar hernias (TLH) representing an even rarer subset. Due to their rarity, there is limited consensus on optimal surgical repair techniques. Traditional TLH repairs typically involve primary closure or mesh reinforcement using open, laparoscopic, or hybrid intra-abdominal approaches. We present three cases of TLH managed with a novel bone tunnel technique, approximating the external oblique musculature to the iliac crest under intra-peritoneal visualization, without the use of mesh. To our knowledge, these are the first reported cases of mesh-free iliac crest fixation in TLH repair.