Full Endoscopic Translaminar Keyhole Diskectomy for Highly Upmigrated Lumbar Disk Herniation: A Case Report

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Spine Surgery

Background:

• Highly upmigrated disk herniation at L5-S1 presents a surgical challenge.
• Traditional approaches may involve extensive bone removal and risk neural injury.

Purpose of the Study:

• To evaluate the safety and efficacy of a full endoscopic translaminar keyhole diskectomy for highly upmigrated disk herniation.
• To describe a novel scope-in-scope technique for accessing and removing herniated disc fragments.

Main Methods:

• A 49-year-old male patient underwent a full endoscopic translaminar keyhole diskectomy.
• A scope-in-scope technique was employed, utilizing a large working cannula and endoscope for fenestration, followed by a smaller system for fragment removal.
• The surgical target was a highly upmigrated disk herniation at the L5-S1 level.

Main Results:

• The surgical procedure resulted in excellent outcomes for the patient.
• The scope-in-scope technique allowed for targeted removal of the herniated disk fragment.
• Minimal bone removal was necessary due to the direct targeting of the herniated fragment.

Conclusions:

• Full endoscopic translaminar keyhole diskectomy is a safe and effective surgical option for highly upmigrated disk herniation.
• This technique minimizes bone resection by directly addressing the herniated fragment.
• The approach reduces the potential for neural injury compared to conventional methods.