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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Percutaneous endoscopic lumbar discectomy via contralateral approach: a technical case report
Jin-Sung Kim1, Gun Choi, Sang-Ho Lee
1Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea.
Spine
|July 26, 2011
Summary
A new contralateral approach for percutaneous endoscopic lumbar discectomy (PELD) effectively treats lumbar disc herniation when standard methods are challenging. This PELD technique offers a viable alternative for selected patients, ensuring nerve root decompression.
Area of Science:
- Minimally invasive spine surgery
- Neurosurgery
- Orthopedic surgery
Background:
- Conventional percutaneous endoscopic lumbar discectomy (PELD) via an ipsilateral transforaminal route faces accessibility challenges with highly down-migrated lumbar disc herniation.
- Anatomical limitations such as a narrow ipsilateral intervertebral foramen can impede standard PELD procedures.
Observation:
- A novel contralateral approach for transforaminal PELD was utilized in five patients presenting with L4-L5 disc herniation.
- This technique was applied to address highly down-migrated disc herniations where ipsilateral access was difficult.
Findings:
- The contralateral PELD technique successfully removed herniated disc fragments, achieving complete nerve root decompression in all treated patients.
- Patients experienced rapid symptom relief, with significant reduction in gluteal and leg pain.
Implications:
- Contralateral PELD represents a valuable alternative surgical option for managing complex lumbar disc herniations when conventional ipsilateral approaches are not feasible.
- This technique expands the utility of PELD in challenging anatomical scenarios, potentially improving outcomes for a wider patient population.