Percutaneous lumbar discectomy and decompression

Abstract

The decrease in the popularity of chemonucleolysis has created a surge of interest in mechanical nuclear decompression and discectomy. Our interest and experience in this unique approach, which permits access to the intervertebral disc without the necessity of violating the spinal canal, dates back to 1973 [3]. Originally, we were utilizing a cannula with the external diameter of 3 mm; however, our subsequent experimental work led us to use a larger diameter sheath to provide an adequate annular opening and permit better access to the intervertebral disc. The intraoperative pressure measurement of a herniated lumbar disc prior to and following the annular fenestration suggests that an adequate fenestration of the annulus, to allow the continuous decompression of the disc, is desirable [2]. A small window in the annulus is easily blocked by blood clots and nuclear debris.