Abstract
Full-endoscopic lumbar discectomy has been an alternative in minimally invasive spine surgery to treat lumbar disc herniation. For the transforaminal approach, high-grade down-migrated disc below the suprapedicular border remains technically challenging and leads to a higher failure rate. Different full-endoscopic techniques regarding the issue have been proposed, including the transforaminal approach with foraminoplasty, contralateral transforaminal approach, and interlaminar or translaminar approach. In terms of anatomy, the pedicle is a barrier to reach the migrated fragment through the posterolateral trajectory. The full-endoscopic instruments allow surgeons to achieve fragmentectomy by creating a “keyhole” on the pedicle. The nerve roots are free of manipulation through the tract toward the target directly. Therefore, a full-endoscopic transpedicular approach can be a solution to treat high-grade downward disc migration. In this chapter, the authors will introduce the techniques of full-endoscopic transpedicular approach step by step.
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References
Choi G, et al. Percutaneous endoscopic approach for highly migrated intracanal disc herniations by foraminoplastic technique using rigid working channel endoscope. Spine (Phila Pa 1976). 2008;33(15):E508–15.
Yeom KS, Choi YS. Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation. J Orthop Sci. 2011;16(3):263–9.
Choi G, et al. Percutaneous endoscopic lumbar herniectomy for high-grade down-migrated L4-L5 disc through an L5-S1 interlaminar approach: a technical note. Minim Invasive Neurosurg. 2010;53(3):147–52.
Inomata Y, et al. Percutaneous endoscopic lumbar discectomy via adjacent interlaminar space for highly down-migrated lumbar disc herniation: a technical report. J Spine Surg. 2018;4(2):483–9.
Krzok G, et al. Transpedicular lumbar endoscopic surgery for highly migrated disk extrusions: preliminary series and surgical technique. World Neurosurg. 2016;95:299–303.
Krzok G, et al. Transpedicular endoscopic surgery for lumbar spinal synovial cyst-report of two cases. J Spine Surg. 2016;2(4):310–3.
Krzok G. Transpedicular endoscopic surgery for highly Downmigrated L5-S1 disc herniation. Case Rep Med. 2019;2019:5724342.
Uniyal P, Choi G, Khedkkar B. Percutaneous Transpedicular Lumbar Endoscopy: A Case Report. Int J Spine Surg. 2016;10:31.
Quillo-Olvera J, Akbary K, Kim JS. Percutaneous endoscopic transpedicular approach for high-grade down-migrated lumbar disc herniations. Acta Neurochir. 2018;160(8):1603–7.
Torun F, Tuna H, Buyukmumcu M, Caglar S, Baysefer A. The lumbar roots and pedicles: a morphometric analysis and anatomical features. J Clin Neurosci. 2008;15(8):895–9.
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Kim, JS., Chen, KT., Choi, G. (2020). Full-Endoscopic Transpedicular Approach. In: Kim, H.S., Mayer, M., Heo, D.H., Park, C.W. (eds) Advanced Techniques of Endoscopic Lumbar Spine Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-15-8253-0_12
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DOI: https://doi.org/10.1007/978-981-15-8253-0_12
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