Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review
L5-S1 disc has always been a difficult disc to target by rigid endoscope because of anatomical limitations. In this study, we have described the technique to overcome difficulty faced during endoscopic disc decompression of high-grade inferior migrated disc at L5-S1. We performed percutaneous endosc...
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Wolters Kluwer Medknow Publications
2018-01-01
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doaj-70d5a7cf699d431fa0b3b27f45b97e052020-11-25T01:03:05ZengWolters Kluwer Medknow PublicationsIndian Journal of Pain0970-53332018-01-0132211612210.4103/ijpn.ijpn_25_18Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical reviewManish RajHyeun S KimKailash KothariAnurag AgarwalSantosh TripathiShobhit BharadwajL5-S1 disc has always been a difficult disc to target by rigid endoscope because of anatomical limitations. In this study, we have described the technique to overcome difficulty faced during endoscopic disc decompression of high-grade inferior migrated disc at L5-S1. We performed percutaneous endoscopic inter-laminar lumbar discectomy (PEILD) for removal of high grade inferiorly migrated disc and preserved the functional structures. After institutional review board approval, details of the patient with high-grade inferior migration at L5-S1 disc were reviewed. The patient was operated by a single specialist with use of the percutaneous endoscopic inter-laminar technique for high-grade inferior migrated extruded disc. Description of our technique & result is the focus of this study. The average VAS score was reduced from 9 pre-operatively to 3 post-operatively & to 1-2 within 2 weeks. Post-operative plantar flexion of foot improved from 2 to 4 immediately and up to 5 within 2 weeks. Ankle jerk reflex improved from 1+ to 2+. The pain severity score on BPI reduced from 9 to 3 postoperatively. Post-operative MRI showed that the high grade inferiorly ruptured disc had been successfully removed. We obtained excellent results in treating inferior extruded disc at L5-S1 using endoscopic inter-laminar approach. Inter-laminar endoscopic discectomy can be used as a safe yet minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a high grade inferior migrated lumbar disc herniation.http://www.indianjpain.org/article.asp?issn=0970-5333;year=2018;volume=32;issue=2;spage=116;epage=122;aulast=RajEndoscopic disc discectomyhigh-grade inferior migrationinterlaminar endoscopic discectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Manish Raj Hyeun S Kim Kailash Kothari Anurag Agarwal Santosh Tripathi Shobhit Bharadwaj |
spellingShingle |
Manish Raj Hyeun S Kim Kailash Kothari Anurag Agarwal Santosh Tripathi Shobhit Bharadwaj Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review Indian Journal of Pain Endoscopic disc discectomy high-grade inferior migration interlaminar endoscopic discectomy |
author_facet |
Manish Raj Hyeun S Kim Kailash Kothari Anurag Agarwal Santosh Tripathi Shobhit Bharadwaj |
author_sort |
Manish Raj |
title |
Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review |
title_short |
Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review |
title_full |
Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review |
title_fullStr |
Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review |
title_full_unstemmed |
Percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated L5-S1 disc: A case report with technical review |
title_sort |
percutaneous endoscopic interlaminar lumbar discectomy for high-grade inferiorly migrated l5-s1 disc: a case report with technical review |
publisher |
Wolters Kluwer Medknow Publications |
series |
Indian Journal of Pain |
issn |
0970-5333 |
publishDate |
2018-01-01 |
description |
L5-S1 disc has always been a difficult disc to target by rigid endoscope because of anatomical limitations. In this study, we have described the technique to overcome difficulty faced during endoscopic disc decompression of high-grade inferior migrated disc at L5-S1. We performed percutaneous endoscopic inter-laminar lumbar discectomy (PEILD) for removal of high grade inferiorly migrated disc and preserved the functional structures. After institutional review board approval, details of the patient with high-grade inferior migration at L5-S1 disc were reviewed. The patient was operated by a single specialist with use of the percutaneous endoscopic inter-laminar technique for high-grade inferior migrated extruded disc. Description of our technique & result is the focus of this study. The average VAS score was reduced from 9 pre-operatively to 3 post-operatively & to 1-2 within 2 weeks. Post-operative plantar flexion of foot improved from 2 to 4 immediately and up to 5 within 2 weeks. Ankle jerk reflex improved from 1+ to 2+. The pain severity score on BPI reduced from 9 to 3 postoperatively. Post-operative MRI showed that the high grade inferiorly ruptured disc had been successfully removed. We obtained excellent results in treating inferior extruded disc at L5-S1 using endoscopic inter-laminar approach. Inter-laminar endoscopic discectomy can be used as a safe yet minimally invasive technique for the treatment of lumbar radiculopathy in the setting of a high grade inferior migrated lumbar disc herniation. |
topic |
Endoscopic disc discectomy high-grade inferior migration interlaminar endoscopic discectomy |
url |
http://www.indianjpain.org/article.asp?issn=0970-5333;year=2018;volume=32;issue=2;spage=116;epage=122;aulast=Raj |
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