title: Minimally invasive percutaneous endoscopic 2 levels adjacent lumbar discectomy through 1 portal skin incision: Preliminary study.
abstract: BACKGROUND
  Acute lumbar disc herniation can occur in every lumbar intervertebral disc space and in multiple levels simultaneously. In the cases of 2 levels adjacent lumbar disc herniations of severe unilateral radiculopathic leg pain caused by compression of the nerve roots, respectively, multiple incision or long incision is generally needed for simultaneous removal of disc fragment in 2 levels.
  
  
  OBJECTIVE
  We proposed the minimally invasive one portal skin incision endoscopic discectomy is effective and safe method to treat 2 levels adjacent lumbar disc herniation.
  
  
  METHODS
  We have experimented total 8 cases of 2 levels adjacent lumbar disc herniation having unilateral radiculopathic pain respectively. All cases are 2 levels adjacent lumbar disc herniation. We have tried a percutaneous endoscopic transforaminal approach through minimal one portal skin incision and remove the two herniated disc materials in the adjacent levels.
  
  
  RESULTS
  The L2-L3 level was involved in 2 patients, L3-L4 level in 6 patients, while the L4-L5 level was involved in 7 patients, L5-S1 level in 1 patient. The mean follow-up was 18.5 months. The mean visual analogue score (VAS) of the patients prior to surgery was 7.75, and the mean postoperative VAS was 2.375. According to Macnab's criteria, 3 patients had excellent results, 4 patients had good results, 1 patient had fair results, and no patient had a poor result; satisfactory results were obtained in 87.5% of the cases.
  
  
  CONCLUSIONS
  The percutaneous endoscopic transforaminal approach through 1 skin portal incision could be effective surgical method in unilateral adjacent 2 levels lumbar disc herniation.
authors.affiliation: Department of Neurosurgery, Hurisarang Hospital, Daejeon, Korea.
authors.forename: Hyeun Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Chosun University, Gwangju, Korea.
authors.forename: Chang Il
authors.initials: CI
authors.lastname: Ju
authors.affiliation: Department of Neurosurgery, Chosun University, Gwangju, Korea.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Chosun University, Gwangju, Korea.
authors.forename: Jong Gyue
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Chosun University, Gwangju, Korea.
authors.forename: Seung Myung
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, Mokpo Christian Hospital, Mokpo, Korea.
authors.forename: Byoung Wook
authors.initials: BW
authors.lastname: Kim
keywords: Adjacent 2 levels disc herniation; one portal; percutaneous endoscopic lumbar discectomy; transforaminal approach