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Minimally invasive removal of a recurrent lumbar herniated nucleus pulposus by the small incised microendoscopic discectomy interlaminar approach
Author(s) -
Koga S,
Sairyo K,
Shibuya I,
Kanamori Y,
Kosugi T,
Matsumoto H,
Kitagawa Y,
Sumita T,
Dezawa A
Publication year - 2012
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2011.00118.x
Subject(s) - medicine , percutaneous , surgery , endoscope , invasive surgery , discectomy , endoscopy , lumbar , lumbar disc herniation , diskectomy , lumbar vertebrae
In this report, we introduce two cases of recurrent herniated nucleus pulposus ( HNP ) at L5‐S1 that were successfully removed using the small incised microendoscopic discectomy ( sMED ) technique, proposed by D ezawa and S airyo in 2011. sMED was performed via the interlaminar approach with a percutaneous endoscope. The patients had previously underdone microendoscopic discectomy for HNP . For the recurrent HNP , the sMED interlaminar approach was selected because the HNP occurred at the level of L5‐S1 ; the percutaneous endoscopic transforaminal approach was not possible for anatomical reasons. To perform sMED via the interlaminar approach, we employed new, specially made devices to enable us to use this technique. In conclusion, sMED is the most minimally invasive approach available for HNP , and its limitations have been gradually eliminated with the introduction specially made devices. In the near future, percutaneous endoscopic surgery could be the gold standard for minimally invasive disc surgery.