Abstract
Posterolateral Percutaneous Endoscopic Discectomy with Partial Pediculotomy for the L1-L2 High-Grade Downward Migrated Disc Herniation
Highlights
Percutaneous endoscopic discectomy (PED) is one of the most useful minimally invasive surgery for lumbar disc herniation (LDH) [1,2]
posterolateral PED (PLPED) with partial pediculotomy was useful for a migrated fragment in patients with poor general conditions
The PED system requires a new device to control the bleeding from the anterior epidural venous plexus (AEVP)
Summary
Percutaneous endoscopic discectomy (PED) is one of the most useful minimally invasive surgical techniques for lumbar disc herniation (LDH). High-grade migrated disc is difficult to treat with only the standard posterolateral approach (posterolateral PED, PLPED). Purpose: To overcome this difficulty, we combined the pediculotomy with PLPED for the treatment of high-grade migrated LDH. The pediculotomy is the recent technic for PED that has been explored with development of high-speed drill. Case report: A 72-year-old man had a 6-month history of left L2 radiculopathy. His general state was too poor to perform general anesthesia and invasive surgery. PLPED with partial pediculotomy was used for complete total removal, which cured his symptoms without any complications. We needed to control 100-ml bleeding from the anterior epidural venous plexus (AEVP)
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