Percutaneous endoscopic translaminar approach for herniated nucleus pulposus in the hidden zone of the lumbar spine.

摘要: Introduction Percutaneous endoscopic discectomy (PED) is the least invasive surgery for lumbar herniated nucleus pulposus (HNP). Most HNP can be removed through traditional PED approaches, but challenging case an that has migrated into hidden zone. We have established a percutaneous translaminar approach (PETA) using system to address such cases. Materials and Surgical Technique Under fluoroscopy, 8-mm skin incision made 5 mm lateral midline. The cannula placed on lamina percutaneously. With specially high-speed drill with diameter of 3.2 mm, 4-mm bone hole made. Through hole, in zone detected. rongeur PED, then decompressed nerve root verified. treated nine cases hidden-zone HNP. In all cases, was successfully removed, as confirmed by postoperative MRI. Clinical outcomes were acceptable: five showed excellent recovery remaining four good. Discussion We introduced PETA technique safely access system. This managing