ID 111291
Author
Goda, Yuichiro Tokushima University
Morimoto, Masatoshi Tokushima University
Mineta, Kazuaki Tokushima University
Kimura, Tetsuya Tokushima University
Nitta, Akihiro Tokushima University
Hama, Shingo Tokushima University
Higuchi, Tadahiro Tokushima University
Jha, Subash C. Tokushima University
Takahashi, Rui Tokushima University
Fukuta, Shoji Tokushima University
Keywords
Percutaneous endoscopic lumbar discectomy
herniated nucleus pulposus
foraminoplasty
lumbosacral junction
transforaminal approach
Content Type
Journal Article
Description
Percutaneous endoscopic discectomy (PED) is the least invasive disc surgery available at present. The procedure can be performed under local anesthesia and requires only an 8 mm skin incision. Furthermore, damage to the back muscle is considered minimal, which is particularly important for disc surgery in athletes. However, employing the transforaminal (TF) PED approach at the lumbosacral junction can be challenging due to anatomical constraints imposed by the iliac crest. In such cases, foraminoplasty is required in addition to the standard TF procedure. A 28-year-old man who was a very active rugby player visited us complaining of lower back and left leg pain. His visual analog scale (VAS) score for pain was 8/10 and 3/10, respectively. MRI revealed a herniated nucleus pulposus at L5-S level. TF-PED was planned ; however, the anatomy of the iliac crest was later found to prevent access to the herniated mass. Foraminoplasty was therefore performed to enlarge the foramen, thereby allowing a cannula to be passed through the foramen into the canal without causing exiting nerve injury. The herniated mass was then successfully removed via the TF-PED procedure. Pain resolved after surgery, and his VAS score decreased to 0/10 for both back and leg pain. The patient returned to full rugby activity 8 weeks after surgery. In conclusion, even with an intracanalicular herniated mass at the lumbosacral junction, a TF-PED procedure is possible if additional foraminoplasty is adequately performed to enlarge the foramen.
Journal Title
The Journal of Medical Investigation
ISSN
13496867
13431420
NCID
AA11166929
AA12022913
Publisher
Faculty of Medicine Tokushima University
Volume
62
Issue
3-4
Start Page
238
End Page
241
Sort Key
238
Published Date
2015-08
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Publisher
departments
University Hospital
Medical Sciences