Direct foraminoplasty in endoscope-assisted transforaminal lumbar interbody fusion for the treatment of lumbar disc herniation

Abstract

Objective As a new minimally invasive surgery developed in recent years, the procedure of endoscope-assisted transforaminal lumbar interbody fusion (TLIF) has not been well described. We herein describe a patient with lumbar disc herniation who underwent direct foraminoplasty and thorough decompression using a self-designed endoscopic trephine in endoscope-assisted TLIF at L4–5. Methods A 57-year-old man presented with a 3-month history of low back and right leg pain. Lumbar spine magnetic resonance imaging indicated protrusion of the L4–5 intervertebral disc in the right posterior direction. The patient underwent endoscopic surgery involving direct foraminoplasty, removal of the L4–5 intervertebral disc, and thorough decompression around the nerve roots. Results During the 1-year follow-up, the patient was generally in good condition and had no significant limitation of lumbar spine activity. Conclusions Endoscopic resection for the treatment of lumbar disc herniation is not a novel concept, but the improvement in the efficacy of endoscope-assisted TLIF and other endoscope-assisted spinal surgeries deserves to be reported. Through the innovation and improvement of surgical equipment for endoscope-assisted TLIF, direct foraminoplasty and thorough decompression can be effectively realized. These advances will help to promote the postoperative efficacy and enhance the prognosis.