Percutaneous endoscopic lumbar discectomy by transiliac approach: a case report.

STUDY DESIGN

Case report.

OBJECTIVE

The authors report a new percutaneous endoscopic lumbar discectomy (PELD) technique for the treatment of lumbar disc herniation with a high iliac crest via a transiliac approach.

SUMMARY OF BACKGROUND DATA

When the iliac crest is high, the L4-L5 and L5-S1 disc spaces are located deep in the pelvis, so they are not easily accessible via a suprailiac route.

METHODS

A 51-year-old man manifested left gluteal and leg pain due to an up-migrated soft disc herniation at the L4-L5 level. Transforaminal PELD via a transiliac approach was performed to remove the herniated fragment, achieving complete decompression of the nerve root.

RESULTS

The symptom was relieved and the patient was discharged the next day.

CONCLUSION

When a conventional transforaminal PELD is impossible due to the presence of a high iliac crest, PELD via a transiliac route could be a alternative option in selected cases.