Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jul;27(Suppl 3):393-402.
doi: 10.1007/s00586-017-5365-3. Epub 2017 Nov 8.

Percutaneous endoscopic lumbar discectomy for high-grade down-migrated disc using a trans-facet process and pedicle-complex approach: a technical case series

Qing-Feng Hu  1 , Hao Pan  2 , Yi-You Fang  2 , Gao-Yong Jia  2
Affiliations
Case Reports

Percutaneous endoscopic lumbar discectomy for high-grade down-migrated disc using a trans-facet process and pedicle-complex approach: a technical case series

Qing-Feng Hu et al. Eur Spine J. 2018 Jul.

Abstract

Purpose: The use of conventional percutaneous endoscopic lumbar discectomy (PELD) for high-grade down-migrated lumbar disc herniation medial to the pedicle via the transforaminal route can result in less favorable outcomes. We report a new PELD technique for the treatment of high-grade down-migrated lumbar disc herniation via a facet process and pedicle-complex approach.

Methods: Three patients with high-grade down-migrated L3-4 and L4-5 disc herniation presented to our hospital. Each underwent PELD via a facet process and pedicle complex approach to remove the herniated fragment and achieve complete decompression of the nerve root.

Results: Patients' symptoms were relieved. Postoperative magnetic resonance imaging showed root decompression. Follow-up 12-month computed tomography revealed no pedicle or facet fracture and healing of the pedicle complex and facet process bone tunnel.

Conclusion: PELD via a facet process and pedicle-complex approach may be an option for high-grade, down-migrated lumbar disc herniation with completely sequestrated nucleus pulposus.

Keywords: Facet process; High-grade down-migration; Lumbar disc herniation; Pedicle complex; Percutaneous endoscopic lumbar discectomy (PELD).

PubMed Disclaimer

References

    1. Spine (Phila Pa 1976). 2005 Nov 15;30(22):2570-8 - PubMed
    1. Neurosurgery. 2006 Feb;58(1 Suppl):ONS59-68; discussion ONS59-68 - PubMed
    1. Spine (Phila Pa 1976). 2007 Oct 15;32(22):2462-6 - PubMed
    1. J Neurosurg. 2001 Apr;94(2 Suppl):216-20 - PubMed
    1. Minim Invasive Neurosurg. 2010 Jun;53(3):147-52 - PubMed

Publication types

Supplementary concepts

LinkOut - more resources