• Paul R A M Depauw, Pravesh S Gadjradj, John S Soria van Hoeve, and Biswadjiet S Harhangi.
• Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
• Acta Neurochir (Wien). 2018 Dec 1; 160 (12): 2473-2477.

BackgroundPercutaneous transforaminal endoscopic discectomy (PTED) has emerged as a less invasive technique to treat symptomatic lumbar disk herniation (LDH). PTED is performed under local anesthesia with the advantage of immediate intraoperative feedback of the patient. In this paper, the technique is described as conducted in our hospital.MethodsPTED is performed under local anesthesia in prone position on thoracopelvic supports. The procedure is explained stepwise: e.g. marking, incision, introduction of the 18-gauge needle and guidewire to the superior articular process, introduction of the TomShidi needle and foraminotomy up to 9 mm, with subsequently removal of disk material through the endoscope. Scar size is around 8 mm.ConclusionPTED seems a promising alternative to conventional discectomy in patients with LDH and can be performed safely.

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