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Percutaneous Transpedicular Lumbar Endoscopy: A Case Report.

Priyank Uniyal¹, Gun Choi¹, Bhushan Khedkkar¹

¹Pohang Wooridul Hospital, Pohang, Korea.

International Journal of Spine Surgery

|December 3, 2016

Summary

Percutaneous transpedicular endoscopy offers a promising solution for challenging lumbar disc herniations. This minimally invasive technique allows for complete decompression of high-grade, down-migrated disc fragments medial to the pedicle.

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Area of Science:

Neurosurgery
Minimally Invasive Spine Surgery
Spinal Endoscopy

Background:

Spine endoscopy has evolved from central debulking to targeted fragmentectomy and disc preservation.
Down-migrated lumbar disc herniations medial to the pedicle are challenging for conventional transforaminal approaches.
Open procedures for these challenging cases risk instability due to extensive bone removal.

Purpose of the Study:

To present a safe and effective technique for lumbar intra-canal high-grade down-migrated disc herniation.
To describe the use of transpedicular endoscopy for lesions medial to the pedicle.
To evaluate the efficacy of this approach for challenging lumbar disc pathologies.

Main Methods:

Percutaneous transpedicular lumbar endoscopy was performed under local anesthesia.

Keywords:

high grade down migrated disc herniation percutaneous transpedicular lumbar endoscopy spine endoscopy

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The technique was applied to two patients with high-grade down-migrated disc herniation and a discal cyst.

The procedures focused on lesions located medial to the pedicle.

Main Results:

Complete decompression was successfully achieved in both cases.
Percutaneous transpedicular lumbar endoscopy demonstrated effective removal of disc material.
The technique provided successful decompression for challenging lumbar disc herniations.

Conclusions:

Transpedicular endoscopy is a promising technique for managing high-grade down-migrated lumbar disc herniations.
Direct visualization during the procedure ensures complete removal of disc material.
This minimally invasive approach offers an alternative to open surgery for challenging disc pathologies.