History and current status of percutaneous arthroscopic disc surgery.
METHODS
The relevant literature and the author's experience with the management of lumbar disc herniation is reviewed.


OBJECTIVE
To describe the history of percutaneous arthroscopic discectomy, and to discuss the indications, the procedure's scientific validity, and its outcome.


BACKGROUND
In contrast to nuclear-debulking procedures, arthroscopic microdiscectomy is target-oriented and capable of retrieving the compressive elements in a carefully selected patient population. The insult to myoligamentous stabilizing structures and intracanalicular tissues is minimal. Extraction of herniated fragments not only can be demonstrated under arthroscopic visualization but also via postoperative imaging studies.


METHODS
Search of the literature and the author's experience with arthroscopic disc surgery.


RESULTS
Arthroscopic microdiscectomy has a learning curve. In properly selected patients, a successful outcome similar to macro- or microdiscectomy may be achieved.


CONCLUSIONS
Proper patient selection is paramount to a successful outcome of arthroscopic disc surgery. Sequestered migrated herniations and large central herniations at L5-S1 in individuals with elevated iliac crests will require open surgery.
Kambin
P
P
Department of Orthopaedic Surgery, Medical College of Pennsylvania, Philadelphia, USA.
Zhou
L
L
D001182:Arthroscopy; D017587:Diskectomy, Percutaneous; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D016896:Treatment Outcome