Translaminar fully endoscopic approach for lumbar disc herniations in the hidden zone

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Minimally Invasive Spine Surgery

Background:

• Minimally invasive endoscopic procedures are increasingly popular for lumbar disc herniations (LDHs).
• Standard endoscopic techniques (interlaminar, transforaminal) are effective for most LDHs.
• Migrated LDHs in the "hidden zone" pose surgical challenges due to accessibility and instability risks.

Purpose of the Study:

• To describe the translaminar fully endoscopic approach (TFEA) for managing LDHs in the "hidden zone".
• To present TFEA as a safe and effective minimally invasive alternative for complex LDH cases.

Main Methods:

• Detailed description of the translaminar fully endoscopic approach (TFEA).
• Focus on managing cranially or caudally migrated lumbar disc herniations.
• Minimizing anatomical disruption and preserving spinal stability during the procedure.

Main Results:

• The TFEA offers a minimally invasive option for challenging LDH locations.
• This approach aims to reduce morbidity associated with conventional open surgery.
• Preserves spinal stability, unlike techniques requiring extensive facetectomy.

Conclusions:

• The translaminar fully endoscopic approach (TFEA) is a viable option for treating "hidden zone" lumbar disc herniations.
• TFEA expands the application of endoscopic spine surgery.
• This technique minimizes anatomical disruption and preserves spinal stability.