Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation.
J Vis Exp
; (188)2022 10 14.
Article
in En
| MEDLINE
| ID: mdl-36314789
ABSTRACT
We report a novel technique for C-arm free transtubular L5 nerve decompression under CT-based navigation to reduce the radiation hazard. This procedure is performed under general anesthesia and neuromonitoring. The patient is placed in a prone position on an operating carbon table. A navigation reference frame is placed percutaneously into the contralateral sacroiliac joint or spinous process. Then, CT scan images are obtained. After instrument registration, the L5-S1 foraminal level is confirmed with a navigated probe, and the entry point is marked. Using an approximately 2 cm skin incision, the subcutaneous tissue and muscles are dissected. The navigated first dilator is aimed at the L5-S1 Kambin's triangle, and sequential dilation is performed. The 18 mm tube is used and fixed to the frame. The bone around the Kambin's triangle is removed with a navigated burr. For lateral disc herniation, the L5 nerve root is identified and retracted, and the disc fragment is removed. The navigation-guided tubular endoscopic decompression is an effective procedure. There is no radiation hazard to the surgeon or the operating room staff.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Intervertebral Disc Displacement
Limits:
Humans
Language:
En
Journal:
J Vis Exp
Year:
2022
Document type:
Article