Javier Quillo-Olvera1, Kutbuddin Akbary1, Jin-Sung Kim2. 1. Spine Center, Department of Neurosurgery and The Catholic Central Laboratory of Surgery (CCLS), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, South Korea. 2. Spine Center, Department of Neurosurgery and The Catholic Central Laboratory of Surgery (CCLS), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, South Korea. mddavidk@gmail.com.
Abstract
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.
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.