Journal of neurological surgery. Part A, Central European neurosurgery
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J Neurol Surg A Cent Eur Neurosurg · Jan 2018
Case ReportsCombination of Transforaminal and Interlaminar Percutaneous Endoscopic Lumbar Diskectomy for Extensive Down-migrated Disk Herniation.
The technique and instrumentation of percutaneous endoscopic lumbar diskectomy (PELD) have significantly improved. Thus its indications have been gradually expanding. Down-migrated disk, in particular, is regarded inaccessible by rigid instrumentation due to poor visualization and limited accessibility. We introduce a combination of transforaminal and interlaminar PELD for extensive down-migrated disk herniation at the L4-L5 level. ⋯ It is difficult to remove entire disk fragments using only a transforaminal or interlaminar approach for extensive down-migrated disk herniation. Therefore a combination of transforaminal and interlaminar PELD may be effective for extensive down-migrated disk herniation at L4-L5.