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Dr nitin garg

Endoscopic discectomy

A 25 year old patient presented with severe left sided L5 radicular distribution pain. MRI showed a far-lateral disc prolapse with root compression. He underwent percutaneous endoscopic lumbar discectomy under local anaesthesia using the "Gore Endoscopic set". Holmium laser was used to fulgurate and evaporate the disc fragment and relieve the pressure on the compressed nerve root.
Far-lateral disc prolapse, also known as extra-foraminal disc is rare entity. Surgery for removing this disc prolapse requires an approach lateral to the facet. Some surgeons have even recommended removal of teh facet and fixation. Endoscopy has made removal of such disc prolapse less invasive with preservation of the facet. A lateral approach to the foramen is used with help of a specially designed endoscope to remove the prolapsed disc and relieve the root compression. The benefit of this procedure includes safety as this is done under local anaesthesia and minimal morbidity and preservation of the facets.
This proedure is useful for patients with a unilateral disc prolapse preferably at L3-4/L4-5 levels.

Pre-op MRI showing a far lateral disc prolapse on the left

Post-op MRI showing adequately decompressed foramina and removal of prolapsed disc fragment

Procedure done under local aaesthesia with mild sedation

Intra-op photo with intermittent C-arm guidance
Dr Nitin Garg