Recurrent higher lumbar disc herniation handled through the transforaminal strategy utilizing microendoscopy-assisted lumbar discectomy: a case report.
J Med Case Rep. 2018 Apr 27;12(1):110
Authors: Takagi Y, Yamada H, Ebara H, Hayashi H, Kidani S, Toyooka Ok, Kitano Y, Kagechika Ok, Tsuchiya H
BACKGROUND: Though microendoscopy-assisted lumbar discectomy for lateral or extraforaminal lumbar disc herniations through the lateral strategy has beforehand been reported, microendoscopy-assisted lumbar discectomy for central or paramedian disc herniations through the lateral strategy has not been reported. We report the primary case of recurrent higher lumbar disc herniation (L2-L3) handled with microendoscopy-assisted lumbar discectomy through the transforaminal strategy. No microendoscopy-assisted lumbar discectomy for recurrent higher lumbar disc herniation through the transforaminal strategy has beforehand been reported. Percutaneous endoscopic lumbar discectomy through the transforaminal strategy could be very helpful as a minimally invasive surgical procedure for disc herniations. We utilized percutaneous endoscopic lumbar discectomy through the transforaminal strategy, and invented a brand new microendoscopy-assisted lumbar discectomy through the transforaminal strategy.
CASE PRESENTATION: A 79-year-old Japanese man was operatively managed for recurrent L2-L3 herniation. An 18 mm pores and skin incision was made roughly 70 mm from the midline to the lateral aspect to permit a sufficiently angled trajectory to the extraforaminal house. The transforaminal strategy was used. The exiting nerve root was recognized alongside its course inferior to the pedicle. The lateral portion of the pars interarticularis and the aspect joint was eliminated utilizing a high-speed drill beneath the steering of an endoscope. The tip of the endoscope was set on the lateral aspect of the dura mater. The dura mater was retracted medially and gently, and the herniated disc fragments have been eliminated safely. All signs have been relieved postoperatively. Postoperative magnetic resonance imaging demonstrated disappearance of all herniated disc fragments. A postoperative three-dimensional computed tomographic scan demonstrated the entire preservation of the aspect joint.
CONCLUSIONS: That is the primary report of a case of recurrent higher lumbar disc herniation handled with microendoscopy-assisted lumbar discectomy through the transforaminal strategy. This process permits for using a nerve retractor and different devices to detach adhesions from the dura mater. This process has the benefits of clear visualization of the dura mater, exiting nerve root, and traversing nerve root, and diminished danger of nerve damage, and full preservation of the articular floor of the aspect joint.
PMID: 29699583 [PubMed – in process]