Treatment of lumbar disc herniations by interventional fluoroscopy-guided endoscopy.

The neurointerventional transforaminal endoscopic approach to sequestered disk herniation is a minimally invasive alternative to established microsurgical techniques. In addition to those techniques approaching the nucleus like APLD, the transforaminal approach allows the removal of dislocated sequesters in the epidural space. The main steps of the procedure are fluoroscopy-guided, so a good experience with fluoroscopy based interventional techniques is helpful, but the technique has a significant learning curve. If familiar with the different steps, it allows nearly every lumbar disk herniation to be treated with a very short hospital stay and short rehabilitation time. The paper describes in detail the steps of the procedure, the difficulties and advantages and gives a short review of the relevant literature.