OBJECTIVE: The purpose of this study was to evaluate the efficacy of a transforaminal suprapedicular approach, semi-rigid flexible curved probe, and 3-dimensional reconstruction computed tomography (3D-CT) with discogram in the endoscopic treatment of non-contained lumbar disc herniations. METHODS: The subjects were 153 patients with difficult, non-contained lumbar disc herniations undergoing endoscopic treatment. The types of herniation were as follows : extraforaminal, 17 patients; foraminal, 21 patients; high grade migration, 59 patients; and high canal compromise, 56 patients. To overcome the difficulties in endoscopic treatment, the anatomic structures were analyzed by 3D reconstruction CT and the high grade disc was extracted using a semi-rigid flexible curved probe and a transforaminal suprapedicular approach. RESULTS: The mean follow-up was 18.3 months. The mean visual analogue scale (VAS) of the patients prior to surgery was 9.48, and the mean postoperative VAS was 1.63. According to Macnab's criteria, 145 patients had excellent and good results, and thus satisfactory results were obtained in 94.77% cases. CONCLUSION: In a posterolateral endoscopic lumbar discectomy, the difficult, non-contained disc is considered to be the most important factor impeding the success of surgery. By applying a semi-rigid flexible curved probe and using a transforaminal suprapedicular approach, good surgical results can be obtained, even in high grade, non-contained disc herniations.
Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Humans

The authors report a case of far lateral disc herniation at L4-5 found one year after percutaneous laser lumbar discectomy. The patient was found to be suffering from new-onset right lumbar radiculopathy 6 months after his first operation, and post operative lumbar MRI confirmed a far lateral extraforaminal disc herniation at L4-5, with compression of the nerve. This corresponded to the nucleotomy site of the probe. The patient underwent surgery employng the combined paraspinal intertransverse and interlaminar approach, and his symptoms were relieved. This case emphasizes the importance of removing nuclear material, and shows that remaining material can herniate through a percutaneous discectomy window.
Diskectomy* ; Diskectomy, Percutaneous ; Humans ; Magnetic Resonance Imaging ; Radiculopathy

Operative methods are changing from aggressive open methods to less invasive methods including microscopic discectomy and various kinds of percutaneous methods. In spite of having definite advantages, percutaneous methods still have limited indications and no uniformly convincing clinical results. Microscopic discectomy has advantages of those of open methods and percutaneous methods. A review of clinical results of operative treatment for lumbar disc herniation shows favorable long-term results. For the better long-term results, we should understand the proper indications of each treatment modalities.
Diskectomy

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

Thepercutaneous treatmentof lumbardisc diseasewithlaser energyhas recently emerged as an alternative to standard open surgery or mechanical percutaneous methods. The indications of percutaneousendoscopic laser discectomy should, however, be well evaluated according to clinical and morphological criteria. We report three cases of herniated lumbar disc treated with conventional open surgery after the failure of laser discectomy.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

No abstract available.
Diskectomy*

BACKGROUND: The enSpire™ interventional discectomy system is a new device for treating percutaneous disc decompression (PDD). The outcomes of using the enSpire™ for lumbar disc herniation have not been previously reported. The aim of this study was to determine the clinical effectiveness and safety of the enSpire™ interventional discectomy system for lumbar disc herniation with radiating pain. METHODS: Twelve patients with lumbar disc herniation with radiating leg pain were enrolled in the study. All patients received PDD using enSpire™. Numeric rating scale (NRS) scores for pain and Oswestry Disability Index (ODI) scores were obtained initially and after 1 and 3 months. The patients were divided into 2 groups: Group 1, in which the NRS score improved by more than 50% at 3 months after procedure, and Group 2, in which the NRS score remained the same or improved by less than 50%. RESULTS: After PDD using the enSpire™, the NRS scores decreased from 6.9 ± 1.2 to 2.8 ± 2.7; and ODI scores decreased from 25.8 ± 4.6 to 18.2 ± 5.5. No statistical differences occurred between Group 1 (n = 8) and Group 2 (n = 4) except in the duration of prior illness. CONCLUSIONS: The enSpire™ interventional discectomy system is effective and safe over the short-term, minimally invasive, and easy to use.
Decompression* ; Diskectomy* ; Diskectomy, Percutaneous ; Humans ; Intervertebral Disc Displacement ; Leg ; Treatment Outcome