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Percutaneous Endoscopic Intra-annular Subligamentous Herniotomy for Large Central Disc Herniation: A Technical Case Report

Lee, Sang-Ho MD, PhD*; Choi, Kyung-Chul MD, PhD*; Baek, Oon Ki MD, PhD; Kim, Ho Jin MD*; Yoo, Seung-Hwa ME

doi: 10.1097/BRS.0000000000000239
Case Report

Study Design. Technical case report.

Objective. To describe the novel technique of percutaneous endoscopic herniotomy using a unilateral intra-annular subligamentous approach for the treatment of large centrally herniated discs.

Summary of Background Data. Open discectomy for large central disc herniations may have poor long-term prognosis due to heavy loss of intervertebral disc tissue, segmental instability, and recurrence of pain.

Methods. Six consecutive patients who presented with back and leg pain, and/or weakness due to a large central disc herniation were treated using percutaneous endoscopic herniotomy with a unilateral intra-annular subligamentous approach.

Results. The patients experienced relief of symptoms and intervertebral disc spaces were well maintained. The annular defects were noted to be in the process of healing and recovery.

Conclusion. Percutaneous endoscopic unilateral intra-annular subligamentous herniotomy was an effective and affordable minimally invasive procedure for patients with large central disc herniations, allowing preservation of nonpathological intradiscal tissue through a concentric outer-layer annular approach.

Level of Evidence: N/A

Percutaneous endoscopic unilateral intra-annular subligamentous herniotomy was an effective and affordable minimally invasive procedure for patients with large central disc herniations, allowing preservation of nonpathological intradiscal tissue through a concentric outer-layer annular approach.

*Department of Neurosurgery, Wooridul Spine Hospital, Seoul, Korea

Department of Neurosurgery, Daegu Wooridul Spine Hospital, Daegu, Korea; and

Wooridul Institute for Biomedical Science and Technology, Seoul, Korea.

Address correspondence and reprint requests to Kyung-Chul Choi, MD, PhD, Department of Neurosurgery, Wooridul Spine Hospital, 47-4 Cheongdam-Dong, Gangnam-Gu, Seoul, 130-100, South Korea; E-mail: chul5104@hanmail.net

Acknowledgment date: August 16, 2013. Revision date: November 18, 2013. Acceptance date: November 26, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Wooridul Spine Foundation grant funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins