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Erschienen in:
21.06.2018 | How I Do it - Spine - Other
Percutaneous endoscopic transpedicular approach for high-grade down-migrated lumbar disc herniations
Erschienen in: Acta Neurochirurgica | Ausgabe 8/2018
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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.