ID | 111291 |
Author |
Sakai, Toshinori
Tokushima University
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Matsuura, Tetsuya
Tokushima University
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Hamada, Daisuke
Tokushima University
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Nishisho, Toshihiko
Tokushima University
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Goda, Yuichiro
Tokushima University
Morimoto, Masatoshi
Tokushima University
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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
Sairyo, Koichi
Tokushima University
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|
Keywords | Percutaneous endoscopic lumbar discectomy
herniated nucleus pulposus
foraminoplasty
lumbosacral junction
transforaminal approach
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Content Type |
Journal Article
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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.
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Journal Title |
The Journal of Medical Investigation
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ISSN | 13496867
13431420
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NCID | AA11166929
AA12022913
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Publisher | Faculty of Medicine Tokushima University
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Volume | 62
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Issue | 3-4
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Start Page | 238
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End Page | 241
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Sort Key | 238
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Published Date | 2015-08
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EDB ID | |
DOI (Published Version) | |
URL ( Publisher's Version ) | |
FullText File | |
language |
eng
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TextVersion |
Publisher
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departments |
University Hospital
Medical Sciences
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