Percutaneous lumbar discectomy and decompression

  • P. Kambin


The decrease in the popularity of chemonucleolysis has created a surge of interest in mechanical nuclear decompression and discectomy. Our interest and experience in this unique approach, which permits access to the intervertebral disc without the necessity of violating the spinal canal, dates back to 1973 [3]. Originally, we were utilizing a cannula with the external diameter of 3 mm; however, our subsequent experimental work led us to use a larger diameter sheath to provide an adequate annular opening and permit better access to the intervertebral disc. The intraoperative pressure measurement of a herniated lumbar disc prior to and following the annular fenestration suggests that an adequate fenestration of the annulus, to allow the continuous decompression of the disc, is desirable [2]. A small window in the annulus is easily blocked by blood clots and nuclear debris.


Intervertebral Disc Nucleus Pulposus Annulus Fibrosis Kirschner Wire Cauda Equina Syndrome 
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  1. 1.
    Hijikata SA (1987) Percutaneous nucleotomy. Int Symp Graduate Hospital, University of Pennsylvania, Philadelphia, March, 1987Google Scholar
  2. 2.
    Kambin P, Brager MD (1987) Percutaneous posterolateral discectomy. Anatomy and mechanism. Clin Orthop 223: 145Google Scholar
  3. 3.
    Kambin P, Gellman H (1983) Percutaneous lateral discectomy of the lumbar spine: a preliminary report. Clin Orthop 174: 127Google Scholar
  4. 4.
    Kambin P, Nixon JE, Chait A (1987) Bulging annulus pathophysiology and roentgenographic findings. Scientific Program, Am Acad Orthopaedic Surgeons, San Francisco, January, 1987Google Scholar
  5. 5.
    Kambin P, Sampson S (1986) Posterolateral percutaneous suction — excision of herniated lumbar intervertebral discs: report of interim results. Clin Orthop 207: 37PubMedGoogle Scholar
  6. 6.
    Kambin P, Sampson S (1984) Laminectomy vs. percutaneous lateral discectomy: a comparative study. Orthop Trans 8: 408Google Scholar
  7. 7.
    MacNab I (1986) Disc degeneration and low back pain. Proc R Coll Phys Surg Can, 1952. Clin Orthop 208: 3Google Scholar
  8. 8.
    Ritchie TH, Fahrni WT (1970) Age changes in the lumbar intervertebral disc. Canada J Surg 13: 63Google Scholar

Copyright information

© Springer-Verlag/Wien 1988

Authors and Affiliations

  • P. Kambin
    • 1
  1. 1.Department of Orthopaedic Surgery, Disc Treatment and Research CenterUniversity of Pennsylvania School of Medicine, The Graduate HospitalPhiladelphiaUSA

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