The technique of percutaneous endoscopic lumbar discetomy (PELD) in the transforaminal approach has evolved over the years due to the advances in endoscopic photology and instrumentation and become the most popular technique for lumbar disc herniation. Although PELD offers many advantages, the indications of PELD are limited mostly to non-migrated or low-migrated disc herniation. It is very difficult for PELD in the transforaminal approach to remove the highly migrated disc fragment successfully due to the anatomic barrier. Nowadays, with the advances of instruments and technique, it might be possible for PELD in the transforaminal approach to remove these high-grade migrated disc fragments. The purpose of this study was to describe a technique to effectively treat highly migrated disc herniation via 2 working channels.
Key words: Percutaneous endoscopic lumbar discectomy, far-migrated disc herniation, working channels.