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Endoscopic Discectomy of Rostrally and Caudally Migrated Lumbar Disc Herniations; A Technique Video – Lumbar Fusion

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The article discusses the surgical treatment of extremely migrated caudal and rostral lumbar disc herniations, which can be challenging. The traditional open technique often requires more bone resection, leading to rare but significant complications. However, endoscopic discectomy is a safe alternative with acceptable complication rates. It offers excellent visualization and maneuverability while minimizing soft tissue trauma and bony resection, resulting in less postoperative pain, opioid consumption, and quicker recovery. The article provides a surgical technique guide for endoscopic discectomy and presents two patient cases with high-grade lumbar disc herniations. The risks, benefits, and alternatives to surgery were discussed, and the patients consented to the procedure. The article emphasizes that the video should not replace hands-on training

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Surgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative to traditional open surgery with acceptable complication rates.^(1-4) Endoscopic discectomy provides the advantage of excellent visualization and maneuverability…

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World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.ABSTRACTSurgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative,

World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.

ABSTRACT

Surgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative to traditional open surgery with acceptable complication rates.1-4 Endoscopic discectomy provides the advantage of excellent visualization and maneuverability while minimizing soft tissue trauma and bony resection which can result in less postoperative pain, opioid consumption, and quicker recovery.5 We present a surgical technique guide for endoscopic discectomy of two patients with very high rostral (grade 1) and caudal (grade 6) lumbar disc herniations as graded by Ahn’s modification of the Lee-Kim grading classification.6,7 Risks, benefits and alternatives to surgery discussed with patients and the patients consented to the procedure. This video is not a replacement to hands on training.

PMID:37625632 | DOI:10.1016/j.wneu.2023.08.074

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Endoscopic Discectomy of Rostrally and Caudally Migrated Lumbar Disc Herniations; A Technique Video

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World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.ABSTRACTSurgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative

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