title: Laparoscopic lumbar discectomy.
abstract: BACKGROUND
  Minimally invasive spine surgery is gaining popularity. Results of currently used percutaneous posterior techniques fall short of standard open microdiscectomy. Using a posterior percutaneous technology with an anterior laparoscopic approach may improve results and still maintain the advantages of a minimally invasive procedure.
  
  
  METHODS
  Patients with symptomatic lumbar protruded discs confirmed by computed tomography or magnetic resonance imaging were offered the procedure. Transperitoneal visualization of the retroperitoneum was supplemented with fluoroscopic guidance. A small window made to the disc allowed the percutaneous nucleotome to be inserted through the anterior annulus. The automated nucleotome aspirated the nucleus, leaving the ligaments intact.
  
  
  RESULTS
  All patients underwent successful dissection and placement of the nucleotome. Of the 23 patients, 21 left the hospital in less than 24 hours. The initial neurologic outcome is that 20 out of 23 patients had improved symptoms or were asymptomatic. Complications were minimal.
  
  
  CONCLUSIONS
  Laparoscopic lumbar discectomy is safe, and for carefully selected patients, can be an alternative to posterior microdiscectomy.
authors.affiliation: Department of Minimally Invasive Surgery, Legacy Portland Hospital, Oregon, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Zelko
authors.forename: J
authors.initials: J
authors.lastname: Misko
authors.forename: L
authors.initials: L
authors.lastname: Swanstrom
authors.forename: J
authors.initials: J
authors.lastname: Pennings
authors.forename: T
authors.initials: T
authors.lastname: Kenyon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017587:Diskectomy, Percutaneous / Q000379:methods*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome