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Percutaneous endoscopic intra-annular subligamentous herniotomy for large central disc herniation: a technical case
Sang-Ho Lee1, Kyung-Chul Choi, Oon Ki Baek
1*Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea †Department of Neurosurgery, Daegu Wooridul Spine Hospital, Daegu, Korea; and ‡Wooridul Institute for Biomedical Science and Technology, Seoul, Korea.
Study Design:
Technical case report.
Objective:
To describe the novel technique of percutaneous endoscopic herniotomy using a unilateral intra-annular subligamentous approach for the treatment of large centrally herniated discs.
Summary Of Background Data:
Open discectomy for large central disc herniations may have poor long-term prognosis due to heavy loss of intervertebral disc tissue, segmental instability, and recurrence of pain.
Methods:
Six consecutive patients who presented with back and leg pain, and/or weakness due to a large central disc herniation were treated using percutaneous endoscopic herniotomy with a unilateral intra-annular subligamentous approach.
Results:
The patients experienced relief of symptoms and intervertebral disc spaces were well maintained. The annular defects were noted to be in the process of healing and recovery.
Conclusion:
Percutaneous endoscopic unilateral intra-annular subligamentous herniotomy was an effective and affordable minimally invasive procedure for patients with large central disc herniations, allowing preservation of nonpathological intradiscal tissue through a concentric outer-layer annular approach.
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