Background: Surgical options for removing high-grade down-migrated lumbar disc herniations located medial to the pedicle include an extensive laminectomy and facetectomy. A direct percutaneous endoscopic approach through the pedicle for reaching the herniated disc without risk of iatrogenic instability is feasible.
Method: The transpedicular approach consists of creating a tunnel through the pedicle. Subsequently, access to the parapedicular epidural space is obtained, and downward migrated disc can be removed.
Conclusion: This technique allows to reach migrated herniations medially to the pedicle safely and effectively.
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| http://dx.doi.org/10.1007/s00701-018-3586-9 | DOI Listing |
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