Percutaneous discectomy: an anatomical study.

Percutaneous discectomy is a viable alternative in the treatment of herniated intervertebral discs of the lumbar spine. Anatomical analysis of the retroperitoneal surgical path utilizing computed tomography suggests that the risk of vascular injury is negligible at the L-4, L-5 level, but substantial at the L-5, S-1 level. In addition, one-third of patients otherwise suitable for percutaneous discectomy have segments of bowel obstructing the surgical path. Obtaining an abdominal computed tomographic scan with the patient in the surgical position seems to be a valuable screening technique in the evaluation of candidates for this procedure.