Percutaneous endoscopic transpedicular approach for high-grade down-migrated lumbar disc herniations
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.
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.
This technique allows to reach migrated herniations medially to the pedicle safely and effectively.
KeywordsEndoscopic spine surgery Disc herniation Minimally invasive Transpedicular
Magnetic resonance imaging
Percutaneous endoscopic lumbar discectomy
Visual analog scale
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Conflict of interest
The authors declare that they have no conflict of interest. This manuscript has not been submitted elsewhere.