Transforaminal Full-endoscopic Discectomy under Local Anesthesia for Extraforaminal Calcified Lumbar Disc Herniation:...

Calcified lumbar disc herniation is a challenging subtype of lumbar disc herniation to treat owing to high associated risks of nerve root injury and dural tears. Traditional treatments favor open surgery, but recent advances have increased the use of full-endoscopic discectomy. The patient was a 72-year-old woman with a 4-year history of severe right lower extremity pain. Computed tomography indicated right foraminal stenosis at L2/3 caused by extraforaminal calcified lumbar disc herniation. Full-endoscopic discectomy was performed under local anesthesia through a transforaminal approach. Drilling was conducted within the herniated disc; next, the calcification was broken and removed piece by piece. Symptoms improved after the surgery, and the calcified lumbar disc herniation disappeared. In conclusion, transforaminal full-endoscopic discectomy under local anesthesia is a safe and effective approach for calcified lumbar disc herniation, especially in cases with extraforaminal involvement. The technique described in this study, "intradiscal drilling," avoids the need to detach adhesions, minimizing the risk of nerve injury.