Technique of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation

Abstract

Percutaneous Transforaminal Endoscopic Discectomy is a minimally invasive surgery with little pain, less blood loss, less hospital stay and the surgery can be done in local anesthesia, which was started during late 20 th century. Kambin and Gellmann in 1973 in the United States and Hijikata in Japanin 1977 individually preformed posterolateral percutaneous nucleotomy for the resection of the nucleus pulposus and release of compressed exiting nerve root, which is now spreading through the world and many surgeons are developing their skill but it needs experience and patience for successful outcomes. Along with advanced instruments now the surgery can be performed only giving a small skin incision of 8-10 mm and is as effective as the conventional method of surgery and open microdiscectomy surgery for the treatment of symptomatic lumbar disc herniation. In this review, we are explaining the technique of minimally invasive Percutaneous Transforaminal Endoscopic Discectomy surgery along its advantages and complications which can be encountered while performing this technique.

A comparative study on short-term therapeutic effects of percutaneous transforaminal endoscopic discectomy and microendoscopic discectomy on lumbar disc herniation

“…Despite a long period of MED’s introduction from abroad, it is very critical to master its indications for hospitals that initially conduct such operations 15,16. The elderly patients with multi-segmental LDH and stenosis are not suitable to choose MED treatment 17. In case of recurrence after surgery, it is generally not recommended to perform MED surgery, because it is difficult to enter the spinal canal, which may easily damage the dural sac and cauda equina 18.…”

Feasibility of Endoscopic Lumbar Discectomy in a Remote Government Hospital in Thailand: A Cost-Utility Analysis

“…The herniated disc was removed using the inside-out technique. To corroborate the complete removal of the herniated disc, the cannula was moved towards the epidural space, and pulsation of the dural sac was observed, which confirmed the indication for decompression [ 12 ].…”

The Strategy and Early Clinical Outcome of Percutaneous Full-Endoscopic Interlaminar or Extraforaminal Approach for Treatment of Lumbar Disc Herniation

“…Endoscopic surgery has some advantages, including clear visualization, less damage to the paraspinal muscle and other normal tissues, good cosmetic effect, and reduced patient morbidity with early return to work [ 3 , 4 ]. Posterolateral working channel of transforaminal endoscopic discectomy is a popular endoscopic technique [ 5 , 6 ]. But it has several disadvantages, including that it can not effectively deal with lumbar disc herniation located mainly in spinal canal, complicated puncture techniques, overexposure to X-rays, and insufficient treatment of L5S1 disc protrusion [ 3 , 6 ].…”