Neurospine.  2020 Jul;17(Suppl 1):S81-S87. 10.14245/ns.2040166.060.

Transforaminal Endoscopic Lumbar Discectomy for L5–S1 Disc Herniation With High Iliac Crest: Technical Note and Preliminary Series

Affiliations
  • 1Department of Neurosurgery, Chang Gung Memorial Hospital Chiayi, Puzi City, Taiwan
  • 2Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
  • 3Department of Neurosurgery, China Medical University and Hospital, Taichung, Taiwan
  • 4Department of Orthopaedic Surgery, China Medical University Beigang Hospital, Yunlin County, Taiwan
  • 5Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
  • 6Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan
  • 7School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
  • 8College of Nursing and Health Sciences, Dayeh University, Changhua County, Taiwan

Abstract

With the trend of minimally invasive spine surgery, full-endoscopic lumbar discectomy (FELD) has evolved with the advancement of the optics and instruments. Regarding the techniques, the transforaminal and interlaminar approach remain the major accesses in FELD. Transforaminal endoscopic lumbar discectomy (TELD) is an effective and safe treatment for herniation of the lumbar disc. More and more evidence supports the TELD in enhancing recovery and decreasing surgical complications. However, the learning curve of TELD remains steep, especially at the L5–S1 level. The iliac crest height is an essential factor in the operability of TELD at the L5–S1 level. In the situation of the high iliac crest, TELD is technically challenging even for an experienced surgeon. Therefore, the authors report their techniques of TELD with foraminoplasty step-by-step and the preliminary results in this report.

Keyword

Endoscopic discectomy; Percutaneous lumbosacral region; Iliac crest
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