How I do it: biportal endoscopic paraspinal approach for recurrent lumbar disc herniation following percutaneous endoscopic lumbar discectomy

Abstract

Background: Although percutaneous endoscopic lumbar discectomy (PELD) has been popularized as an alternative to microscopic lumbar discectomy, it has been reported to be associated with a re-herniation rate of 5-11%. Recurrent lumbar disc herniation (RLDH) might occur not only at the same level previously operated upon but also at the annular penetration site created during PELD procedures.

Method: Biportal endoscopic paraspinal approach (BE-Para) was used for revisional foraminal lumbar discectomy. Procedures and some discussions regarding indications, advantages, potential complications, and ways to avoid complications were described.

Conclusion: BE-Para may be an effective modality for RLDH after PELD.

Keywords: Annular penetration; Biportal endoscopic; Paraspinal approach; Percutaneous endoscopic lumbar discectomy; Recurrent lumbar disc herniation; Revisional lumbar discectomy.