Percutaneous endoscopic intra-annular subligamentous herniotomy for large central disc herniation: a technical case report.
METHODS
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.


BACKGROUND
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.


CONCLUSIONS
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.
Sang-Ho
SH
Lee
Kyung-Chul
KC
Choi
Oon Ki
OK
Baek
Ho Jin
HJ
Kim
Seung-Hwa
SH
Yoo
D000328:Adult; D017587:Diskectomy, Percutaneous / Q000379:methods; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007405:Intervertebral Disc Displacement / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010146:Pain; D010147:Pain Measurement; D055502:Secondary Prevention; D016896:Treatment Outcome; D055815:Young Adult