Percutaneous endoscopic discectomy for extraforaminal lumbar disc herniations: extraforaminal targeted fragmentectomy technique using working channel endoscope.

Study Design: A retrospective analysis of 41 patients operated for excision of soft lumbar extraforaminal disc herniation (EFDH) by percutaneous endoscopic extraforaminal approach under local anesthesia by a new technique.

Objectives: To describe a new and safer percutaneous endoscopic technique for the removal of soft EFDH and report the results on the basis of a new objective criterion modified from Oswestry Disability Index (ODI).

Summary Of Background Data: EFDHs usually occur in older patients and present with atypical symptoms.

Percutaneous endoscopic interlaminar discectomy for intracanalicular disc herniations at L5-S1 using a rigid working channel endoscope.

Objective: Percutaneous endoscopic transforaminal discectomy is often used as a minimally invasive procedure for lumbar disc herniation. However, a transforaminal approach posts limitations at the L5-S1 level owing to anatomic constraints, such as a high iliac crest or small intervertebral foramen and especially for migrated large intracanalicular disc herniations. We discuss the procedure and clinical results of percutaneous endoscopic interlaminar discectomy using a rigid working channel endoscope at the L5-S1 level and the relevant surgical anatomy.

The effect of early isolated lumbar extension exercise program for patients with herniated disc undergoing lumbar discectomy.

Objective: To determine the effects of a postoperative early isolated lumbar extension muscle-strengthening program on pain, disability, return to work, and power of back muscle after operation for herniated lumbar disc.

Methods: Seventy-five patients were randomized into an exercise group (20 men, 15 women) and a control group (18 men, 22 women) to perform a prospective controlled trial of a lumbar extension exercise program in patients who underwent lumbar microdiscectomy or percutaneous endoscopic discectomy. Six weeks after surgery, patients in the exercise group undertook a 12-week lumbar extension exercise program.