The Usefulness of Percutaneous Endoscopic Technique in Multifocal Lumbar Pathology
Single level multi-focal, paracentral, and far-lateral lumbar disc herniations. (a) Preoperative sagittal and axial T2-weight MRI showing multifocal, paracentral, and far-lateral lumbar disc herniations at L3-4. Red arrows: paracentral and extraforaminal disc herniation. (b) Postoperative axial and sagittal T2-weight MRI showing the removed paracentral and far-lateral lumbar disc herniations at L3-4. Red arrows: decompressed area by removal of paracentral and extraforaminal disc herniation. (c) Paracentrally herniated disc materials were removed and decompressed traversing root was seen. PLL: posterior longitudinal ligament. (d) Change of working cannula angle showing the foraminal area. Asterisk: tip of remnant extraforaminal disc; dotted blue line: disc level.