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Acta Neurochirurgica

, Volume 160, Issue 8, pp 1603–1607 | Cite as

Percutaneous endoscopic transpedicular approach for high-grade down-migrated lumbar disc herniations

  • Javier Quillo-Olvera
  • Kutbuddin Akbary
  • Jin-Sung Kim
How I Do it - Spine - Other
Part of the following topical collections:
  1. Spine - Other

Abstract

Background

Surgical options for removing high-grade down-migrated lumbar disc herniations located medial to the pedicle include an extensive laminectomy and facetectomy. A direct percutaneous endoscopic approach through the pedicle for reaching the herniated disc without risk of iatrogenic instability is feasible.

Method

The transpedicular approach consists of creating a tunnel through the pedicle. Subsequently, access to the parapedicular epidural space is obtained, and downward migrated disc can be removed.

Conclusion

This technique allows to reach migrated herniations medially to the pedicle safely and effectively.

Keywords

Endoscopic spine surgery Disc herniation Minimally invasive Transpedicular 

Abbreviations

AP

Anterior-posterior

CT

Computed tomography

MRI

Magnetic resonance imaging

PELD

Percutaneous endoscopic lumbar discectomy

RF

Radiofrequency

VAS

Visual analog scale

Notes

Author contribution

All authors have contributed to the material and preparation of this manuscript.

Compliance with ethical standards

The patient has consented to submission of this “How I Do It” to this journal.

Conflict of interest

The authors declare that they have no conflict of interest. This manuscript has not been submitted elsewhere.

Supplementary material

701_2018_3586_MOESM1_ESM.mov (173.6 mb)
Video 1 We present the step by step of percutaneous endoscopic transpedicular approach for high-grade down-migrated lumbar disc herniations. A real clinical case used to exemplify the technique, and detailed information about the procedure is shown in the video. (MOV 177781 kb)

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Spine Center, Department of Neurosurgery and The Catholic Central Laboratory of Surgery (CCLS), Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea

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