Posterior endoscopic surgery for lumbar disc herniation with contralateral symptoms - a report of two cases

We report two cases of lumbar disc herniation with contralateral nerve root involvement, surgically treated with a microendoscopic disectomy system (METRx-MED system). The nerve root of the symptomatic side (contralateral to the side of the disc herniation) had been compressed to the superior facet by herniated disc from the opposite side. Endoscopic observation revealed inflammatory findings of the nerve root on the symptomatic side, such as fibrosis, adhesion, redness and swelling. In contrast, on the non-symptomatic side (ipsilateral side of the disc herniation), the nerve root had been merely compressed by the herniated disc but did not demonstrate any inflammatory findings. Excision of the herniated disc and decompression of the non-symptomatic nerve root should be done first, approaching from the disc herniation side. After that, through the same approach, the nerve root of the opposite (symptomatic) side should be decompressed.