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Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation

  • Original article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Discectomy of distally, inferiorly migrated disc herniations below midpedicle level of the vertebral body in the lower lumbar spine is known to be very difficult by endoscopy. The purpose of this study was to introduce the technical possibility of percutaneous endoscopic lumbar discectomy using a contralateral transforaminal approach for distally migrated disc herniation.

Methods

We reviewed 12 patients who underwent percutaneous endoscopic lumbar discectomy using the contralateral transforaminal approach for distally migrated disc herniation. Complete removal was verified through postoperative magnetic resonance imaging (MRI) follow-up in all patients. Mean follow-up was 25 months.

Results

Clinical results according to MacNab criteria were excellent in ten patients and good in two. Average visual analogue scale for lower back pain and radicular pain improved from 6.8 and 8.2 preoperatively to 1.5 and 1.4, postoperatively (p < 0.01, respectively).

Conclusion

Percutaneous endoscopic lumbar discectomy using contralateral transforaminal approach can be a useful method in patients with distally migrated disc herniation, and endoscopic navigation of anterior epidural space from the contralateral foramen in the lower lumbar spine is technically possible.

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Acknowledgment

This study was approved by the institutional review board of Kwangju Christian Hospital (KCH 2010-016), Gwangju, Korea. The authors received no funding from any commercial party related directly or indirectly to the subject of this article.

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Authors and Affiliations

  1. Department of Orthopaedics, The Bone Hospital, 1008-17, Sadang 1dong, Dongjak-gu, Seoul, 156-824, Republic of Korea

    Kyeong-seong Yeom

  2. Department of Orthopaedic Surgery, Kwangju Christian Hospital, Gwangju, Republic of Korea

    Yong-soo Choi

Authors
  1. Kyeong-seong Yeom
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  2. Yong-soo Choi
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Correspondence to Yong-soo Choi.

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Yeom, Ks., Choi, Ys. Full endoscopic contralateral transforaminal discectomy for distally migrated lumbar disc herniation. J Orthop Sci 16, 263–269 (2011). https://doi.org/10.1007/s00776-011-0048-0

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  • DOI: https://doi.org/10.1007/s00776-011-0048-0

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