Early Experience with Percutaneous Lateral Discectomy

Abstract

Twenty-one patients are reported who underwent percutaneous lumbar discectomy for a herniated disc and sciatica. The criteria for inclusion in this series included: (1) a protruding disc in the lumbar area causing neural compression; (2) persistent sciatica; (3) failure of conservative treatment; (4) MRI, CT, or myelographic confirmation of the protrusion; (5) chronic low back pain with definite evidence of a protruding disc at the appropriate level. The only contraindication to the procedure is the presence of an extruded fragment. There were twelve males and nine females with an average age of 40. The operation is performed under local anesthesia and by the method of Kambin [3–6]. Twelve cases were at the L4–L5 level, eight were at the L5–S1 level, four were at the L3–L4 level, and one was at the L2–L3 level. Seventeen of 21 patients were relieved of their symptoms. One case was aborted due to inability to pass the cannula beneath arthritic facet joints. One complication occurred early while we were using general anesthetic. We injured an L 5 nerve root causing a permanent foot drop. Major possible complications include: (1) infection; (2) nerve root injury: (3) vascular injury. A success rate of 85% is reported.