J Minim Invasive Spine Surg Tech.  2020 Apr;5(1):26-30. 10.21182/jmisst.2019.00066.

Safe Extraforaminal Docking and Floating Technique in Transforaminal Endoscopic Discectomy for Thoracolumbar Junction for Calcified Disc Herniation: A Case Report and Technical Review Junction for Calcified Disc Herniation

• Wu PH
• Kim HS
• Raorane HD
• Heo DH
• Yi YJ
• Yang KH
• Jang IT

• KMID: 2562059
• DOI: http://doi.org/10.21182/jmisst.2019.00066

Abstract

Objective
Thoracolumbar disc herniation is an uncommon disabling spine condition.
Methods
There is relatively large dura expansion to lateral recess in the thoracolumbar junction leading to potential hazard in docking and execution of endoscopic transforaminal discectomy. Mobile outside in technique had been executed successfully in lumbar disc herniation, we modified the technique to allow safe docking and execution of discectomy in thoracolumbar junction. Herein, we report a case of thoracic twelve lumbar one disc paracentral disc herniation treated with floating transforaminal endoscopic discectomy under local anesthesia.
Results
A 46-year-old man with a 3-months of severe back and radicular pain on the right groin. A diagnosis of right T12/L1 paracentral disc herniation was made, based on clinical and radiological investigations. He underwent percutaneous transforaminal endoscopic thoracolumbar discectomy with floating technique. Over a follow-up of 6 months, a favorable outcome was noted.
Conclusion
Floating technique of transforaminal endoscopic thoracolumbar junction discectomy is a safe and an effective surgical approach for the treatment of thoracolumbar disc herniation. In patients with thoracolumbar disc herniation, careful patient selection and evaluation neural elements anatomy in relation to bony anatomy is important in preparation for endoscopic decompression.

Keyword

Thoracolumbar junction; Calcified disc herniation; Transforaminal; Endoscopic discectomy; Floating technique