title: Percutaneous Transpedicular Lumbar Endoscopy: A Case Report.
abstract: BACKGROUND
  Since Kambin introduced the concept of percutaneous transforaminal disc surgery in 1973, there has been numerous advances in the field of spine endoscopy and the concept of central debulking of the disc has changed to targeted fragmentectomy and disc preservation. The lumbar disc fragments which are down migrated and to the medial aspect of the pedicle are extremely challenging to deal by transforaminal approach even after foraminoplasties and by various other approaches. Therefore most spine surgeons prefer open procedures which requires extensive removal of pars and facet leading to the risk of instability.
  
  
  OBJECTIVE
  To describe a safe and effective technique for lumbar intra-canal high grade down migrated disc herniation, medial to the pedicle by transpedicular endoscopy.
  Two patients underwent percutaneous transpedicular lumbar endoscopy under local anaesthesia for high grade down migrated disc herniation and for discal cyst at the medial aspect of pedicle respectively.
  
  
  RESULTS
  We achieved the complete successful decompression by percutaneous transpedicular lumbar endoscopy.
  
  
  CONCLUSIONS
  Authors found this technique very promising in complete removal of disc material under direct visualisation for high grade down disc herniations.
authors.affiliation: Pohang Wooridul Hospital, Pohang, Korea.
authors.forename: Priyank
authors.initials: P
authors.lastname: Uniyal
authors.affiliation: Pohang Wooridul Hospital, Pohang, Korea.
authors.forename: Gun
authors.initials: G
authors.lastname: Choi
authors.affiliation: Pohang Wooridul Hospital, Pohang, Korea.
authors.forename: Bhushan
authors.initials: B
authors.lastname: Khedkkar
keywords: high grade down migrated disc herniation; percutaneous transpedicular lumbar endoscopy; spine endoscopy