Posterolateral Percutaneous Endoscopic Lumbar Discectomy
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- Create Date July 19, 2004
The technique and equipment for performing posterolateral percutaneous endoscopic lumbar discectomy has evolved dramatically in the past five years. The current level of proficiency brings endoscopic capabilities close to the capabilites of conventional transcanal open operations. The foraminal approach can be used not only for herniated discs, but also for degenerative conditions of the lumbar spine.
The advantage of the foraminal endoscopic technique is the ability to reach, visualize, and treat certain intradiscal and foraminal pathologic lesions without destabilizing the posterior muscle column and facets. Intradiscal visualization is enhanced by chromo-discography combining non-ionic radiographic agents (isovue-300) with indigocarmine dye. This blue dye differentially stains degenerated nucleus.
The learning curve is steep, but once mastered, the surgeon is able to reach any pathologic lesion in the foramen, including noncontained disc herniations, foraminal stenosis, facet cysts, and annular tears.