A New Percutaneous Endoscopic Instrument for Far-migrated Disk Herniation: A Retrospective Single-Institution Study.

Abstract

Compared with the traditional posterior approach, the transforaminal (TF) approach for percutaneous endoscopic lumbar diskectomy (PELD) in patients with disk herniation has a limited resection range that is problematic to treat far-migrated disk herniation. This study examined the usefulness of a newly developed percutaneous endoscopic instrument for far-migrated disk herniation. This retrospective study included 22 patients with migrated disk herniation ≥ 10 mm who underwent transforaminal PELD using the new instrument between August 2014 and May 2017. The new instrument differs from conventional forceps because it has only one jaw that rotates in a plane perpendicular to the mouth opening. The migrated herniated disk is held between the instrument and bone surface, pulled out, and subsequently removed using conventional forceps. Herniated disks that had migrated up to 16 mm were removed successfully in all patients. The new instrument is a useful tool that can expand the resection range of the TF approach for PELD.