Spine Center, Department of Neurosurgery and The Catholic Central Laboratory of Surgery (CCLS), Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, South Korea.
Acta Neurochir (Wien). 2018 Aug;160(8):1603-1607. doi: 10.1007/s00701-018-3586-9. Epub 2018 Jun 21.
Surgical options for removing high-grade down-migrated lumbar disc herniations located medial to the pedicle include an extensive laminectomy and facetectomy. A direct percutaneous endoscopic approach through the pedicle for reaching the herniated disc without risk of iatrogenic instability is feasible.
The transpedicular approach consists of creating a tunnel through the pedicle. Subsequently, access to the parapedicular epidural space is obtained, and downward migrated disc can be removed.
This technique allows to reach migrated herniations medially to the pedicle safely and effectively.
对于位于椎弓根内侧的高位下迁移型腰椎间盘突出症，手术切除的选择包括广泛的椎板切除术和小关节切除术。通过椎弓根直接进行经皮内镜入路到达椎间盘突出部位，不会造成医源性不稳定，是可行的。
经椎弓根入路包括在椎弓根上创建一个隧道。随后，获得椎旁硬膜外腔的通道，并可取出向下迁移的椎间盘。
该技术可安全有效地到达椎弓根内侧的迁移型椎间盘突出症。
