Abstract
The lumbosacral junction presents a challenge for minimally invasive surgery at the L5/S1 level. Although the transforaminal endoscopic approach avoids crossing the spinal canal, with the L5/S1 deep in the pelvis, the superior iliac approach may not be feasible or risk injury to the outlet L5 nerve root (Bai et al., Med Res. 22:1–10, 2017). Even in the presence of normal pelvic anatomy, lesions located more centrally at the L5/S1 level, such as central disc herniation, or facet joint hypertrophy with foraminal stenosis, will require a far lateral portal to approach the lesion, and, therefore, a transiliac approach is indicated. Endoscopic transiliac approach can be used for disc herniation at the L5/S1 level.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Reulen HJ, Muller A, Ebeling U. Microsurgical anatomy of the lateral approach to Extraforaminal lumbar disc Herniations[J]. Neurosurgery. 1996;39(2):345–51. https://doi.org/10.1097/00006123-199608000-00022.
Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33(9):931–9. https://doi.org/10.1097/BRS.0b013e31816c8af7.
Song QC, Zhao Y, Li D, Zhang YK, Fan LH, Li QY, Duan DP, Shi ZB. Percutaneous endoscopic transforaminal discectomy for the treatment of L5-S1 lumbar disc herniation and the influence of iliac crest height on its clinical effects. Exp Ther Med. 2021;22(2):866. https://doi.org/10.3892/etm.2021.10298.
Choi KC, Park CK. Percutaneous endoscopic lumbar discectomy for L5-S1 disc herniation: consideration of the relation between the iliac crest and L5-S1 disc. Pain Physician. 2016 Feb;19(2):E301–8.
Song H, Hu W, Liu Z, et al. Percutaneous endoscopic Interlaminar discectomy of L5–S1 disc herniation: a comparison between intermittent endoscopy technique and full endoscopy technique[J]. J Orthop Surg. 2017;12(1):162. https://doi.org/10.1186/s13018-017-0662-4.
Osman SG, Sherlekar S, Malik A, et al. Endoscopic trans-iliac approach to L5-S1 disc and foramen—a report on clinical experience[J]. Int J Spine Surg. 2014;8:20. https://doi.org/10.14444/1020.
Ruetten S, Komp M, Godolias G. A new full-endoscopic technique for the Interlaminar operation of lumbar disc Herniations using 6-mm endoscopes: prospective 2-year results of 331 patients[J]. Minim Invasive Neurosurg. 2006;49(2):80–7. https://doi.org/10.1055/s-2006-932172.
Devlin VJ, Schwartz DM. Intraoperative neurophysiologic monitoring during spinal surgery[J]. J Am Acad Orthop Surg. 2007;15(9):12. https://doi.org/10.5435/00124635-200709000-00005.
Yeung AT, Yeung CA. Minimally invasive techniques for the Management of lumbar disc herniation[J]. Orthop Clin North Am. 2007;38(3):363–72. https://doi.org/10.1016/j.ocl.2007.04.005.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Yang, D., Zhang, K., Zeng, S. (2023). Endoscopic Treatment of L5-S1 Intervertebral Disc Herniation Via Trans-Iliac Approach. In: Lui, T.H. (eds) Endoscopy of the Spine. Springer, Singapore. https://doi.org/10.1007/978-981-19-7761-9_36
Download citation
DOI: https://doi.org/10.1007/978-981-19-7761-9_36
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-19-7760-2
Online ISBN: 978-981-19-7761-9
eBook Packages: MedicineMedicine (R0)