How I do it: percutaneous transforaminal endoscopic discectomy for lumbar disk herniation

Background Percutaneous transforaminal endoscopic discectomy (PTED) has emerged as a less invasive technique to treat symptomatic lumbar disk herniation (LDH). PTED is performed under local anesthesia with the advantage of immediate intraoperative feedback of the patient. In this paper, the techniqu...

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Bibliographic Details
Published in:	Acta neurochirurgica 2018-12, Vol.160 (12), p.2473-2477
Main Authors:	Depauw, Paul R. A. M., Gadjradj, Pravesh S., Soria van Hoeve, John S., Harhangi, Biswadjiet S.
Format:	Article
Language:	eng
Subjects:	Anesthesia Anesthesia, Local - methods Diskectomy, Percutaneous - adverse effects Diskectomy, Percutaneous - methods Endoscopes Endoscopy Endoscopy - adverse effects Endoscopy - methods Foraminotomy - adverse effects Foraminotomy - methods How I Do it - Spine degenerative Humans Interventional Radiology Intervertebral Disc Degeneration - surgery Intervertebral Disc Displacement - surgery Local anesthesia Lumbar Vertebrae - surgery Medicine Medicine & Public Health Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Patient Positioning - methods Postoperative Complications - etiology Prone position Spine degenerative Surgical Orthopedics
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Summary:	Background Percutaneous transforaminal endoscopic discectomy (PTED) has emerged as a less invasive technique to treat symptomatic lumbar disk herniation (LDH). PTED is performed under local anesthesia with the advantage of immediate intraoperative feedback of the patient. In this paper, the technique is described as conducted in our hospital. Methods PTED is performed under local anesthesia in prone position on thoracopelvic supports. The procedure is explained stepwise: e.g. marking, incision, introduction of the 18-gauge needle and guidewire to the superior articular process, introduction of the TomShidi needle and foraminotomy up to 9 mm, with subsequently removal of disk material through the endoscope. Scar size is around 8 mm. Conclusion PTED seems a promising alternative to conventional discectomy in patients with LDH and can be performed safely.
ISSN:	0001-6268 0942-0940