AMD: The Evolution from Central Nucleotomy to Posterior and Lateral Fragmentectomy
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- Create Date January 14, 1999
The standard technique for arthroscopic microdiscectomy (AMD) began as a nucleotomy procedure that resulted in random and variable amounts of disc fragments removed from the central and posterior central part of the nucleus pulposus. This process, as initially described by Kambin, is now enhanced by new endoscope designs and more exacting techniques to target herniated and degenerated disc tissue, whether contained, extruded, or migrated. The previous indications limiting this procedure to contained herniations no longer holds, as improved visualization makes it possible to remove extruded and migrated fragments.