Revision percutaneous endoscopic lumbar discectomy under the local anesthesia for the recurrent lumbar herniated nucleus pulposus in a high class athlete: A case Report

Abstract

Percutaneous endoscopic discectomy (PED) is a minimally invasive spinal technique and has several advantages compared with open surgery. We describe repeat PED surgery for recurrent herniated nucleus pulposus (HNP). The patient was a 33-year-old handball high level player. Previously, he underwent transforaminal PED under local anesthesia for intracanalicular HNP at L4-5 level about 2 years ago. He could return to his original competitive level. Two years later, he felt low back and right leg pain again when he was playing handball. Magnetic resonance imaging revealed the recurrence of HNP at the same level. We conducted transforaminal PED again using the exact same route as the previous surgery. Although there was a little adhesion around the L5 nerve root, we could easily identify and remove the herniated mass using endoscopic forceps. Immediately after the surgery, the low back and leg pain disappeared. Repeat PED surgery for recurrence of lumbar disc herniation is effective especially for athletes because of the benefits of PED, including surgery under local anesthesia, preservation of normal posterior structures, less postoperative pain, early discharge, and faster return to sports.

A Pilot Study of Percutaneous Interlaminar Endoscopic Lumbar Sequestrectomy: A Modern Strategy to Tackle Medically-Refractory Radiculopathies and Restore Spinal Function

“…Given the respect of muscle and paraspinal tissues, limited intraoperative blood loss, and the short operative time, besides being relevant for all those young patients with sequestered disc fragments, this approach could be potentially suitable in groups of individuals with special requirements: such as patients with obesity, coagulopathies, or for professional athletes seeking an early return to competitions. [34][35][36][37] Over the years the instrumentation for endoscopic spine surgery evolved, and newer models are nowadays available so that beyond the EasyGo system tested in this trial percutaneous interlaminar endoscopic approaches can be performed with other full-endoscopic surgical systems. In the future the choice will be even broader due to the continuous competition between producing companies: for the end-user this clearly represents a good news since competition is usually helpful in bringing down costs of initial acquisition or renting.…”

Therapeutic effect of percutaneous endoscopic lumbar discectomy on lumbar disc herniation and its effect on oxidative stress in patients with lumbar disc herniation

“…Washing with saline performed during surgery could remove inflammatory mediators and prevent the accumulation of by-products. Thus, postoperative pain and the incidence of postoperative infection were reduced (1,17,18). …”

Percutaneous full endoscopic lumbar foraminoplasty for adjacent level foraminal stenosis following vertebral intersegmental fusion in an awake and aware patient under local anesthesia: A case report

“…The percutaneous endoscopic surgery using transforaminal approach is not the procedure that needs laminectomy and removal of the yellow ligament. We had reported that repeat PED surgery for the same level recurrence of lumbar disc herniation (25). Using the exact same transforaminal approach, we could easily remove the fragment of recurrent lumbar disc herniation.…”