ID 111291
著者
合田, 有一郎 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
福田, 昇司 Tokushima University
キーワード
Percutaneous endoscopic lumbar discectomy
herniated nucleus pulposus
foraminoplasty
lumbosacral junction
transforaminal approach
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
The Journal of Medical Investigation
ISSN
13496867
13431420
cat書誌ID
AA11166929
AA12022913
出版者
Faculty of Medicine Tokushima University
62
3-4
開始ページ
238
終了ページ
241
並び順
238
発行日
2015-08
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系