Abstract
The conventional open discectomy is the gold standard for treating extruded lumbar disc herniation, especially in highly migrated lumbar disc herniation. Endoscopic spine surgery is known to be very challenging and technically demanding, in particular for highly migrated disc herniation. However, several studies have reported numerous effective techniques with results approximatively equal to conventional open surgeries or mini-open surgery. In the last few years, an increased number of endoscopic spine surgical techniques have been proposed in order to overcome various issues encountered in traditional endoscopic spine surgery. Nevertheless, surgical approach selection for treating extruded lumbar disc herniation is based on aspects such as anatomical structures, availability of surgical instruments, surgeon’s experience, and the disc herniation location. Advances in endoscopic visualization and instrumentation, as well as an increased demand for minimally invasive procedures, have led to the popularity of Percutaneous Endoscopic Lumbar Discectomy (PELD). PELD is a recent and advanced technique among other minimally invasive spine surgeries (MIS). It includes various kinds of surgical techniques to treat lumbar disc herniation and aims to offer a safe, less invasive surgical procedure for lumbar disc space decompression and removal of nucleus pulposus.
Highlights
Degenerative lumbar disc disease is a common condition affecting approximately 90% of adults population during their lifetime [1, 2]
Percutaneous Endoscopic Lumbar Discectomy (PELD) has enhanced the capabilities of foraminal endoscopic discectomy to deliver surgical results comparable to traditional open spine surgeries in the treatment of common lumbar disc herniations
PELD techniques for treating extruded lumbar disc herniation, especially in migrated or sequestered ones are safe and effective, even though the choice for a suitable surgical approach is based on factors such as anatomical barriers, material availability, cost, the disc herniation location, and the surgeon’s experience
Summary
Degenerative lumbar disc disease is a common condition affecting approximately 90% of adults population during their lifetime [1, 2]. The surgical treatment for this condition has developed from traditional open spine surgeries to minimal access spine surgeries including endoscopic spine surgeries. Percutaneous Endoscopic Lumbar Discectomy (PELD) is a new technique among other Minimally Invasive Spine surgeries (MIS). Later studies have shown varying degrees of success Compared to these procedures, PELD has enhanced the capabilities of foraminal endoscopic discectomy to deliver surgical results comparable to traditional open spine surgeries in the treatment of common lumbar disc herniations. PELD has enhanced the capabilities of foraminal endoscopic discectomy to deliver surgical results comparable to traditional open spine surgeries in the treatment of common lumbar disc herniations The advancement of this new technique emphasized a closer placement of the cannula to the epidural space and the base of the targeted disc herniation. This review is focused on the most common percutaneous endoscopic surgical approaches for a lumbar herniated disc with migration
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