Percutaneous Endoscopic Lumbar Discectomy for L5-S1 Foraminal Disc Herniation with Superior Migration using Contralateral Interlaminar Approach: A Technical Case Report

In cases of L5-S1 foraminal disc herniation with superior migration, it is very difficult to access using rigid endoscope. We attempted a percutaneous endoscopic lumbar discectomy (PELD) via a contralateral interlaminar approach to remove the symptomatic disc and preserve the functional structures. Between January 2013 and January 2014, five patients who received PELD for the disc herniation via the approach were included in this study. Through the approach, we could expose the exiting nerve root without structural damage. We confirmed the appropriate decompression of the lesion with an immediate postoperative MRI, and the clinical outcome was evaluated using a visual analog scale (VAS) score. In all cases, the herniation was removed appropriately. The mean pre-operative VAS score was decreased at the post-operative state, from 7.8±0.84 to 1.4±0.55. We obtained excellent clinical outcomes in treating the migrated disc herniation at the level using PELD via a contralateral interlaminar approach.