Spine Research

Percutaneous Endoscopic Lumbar Discectomy Under Local Anesthesia in Elderly Patients with Combined Spinal Canal Stenosis and Herniated Nucleus Pulposus

Percutaneous endoscopic discectomy (PED) for the lumbar spine was established in the early 2000s. This surgery can be performed under local anesthesia, and results in minimum damage to the back muscles. Thus, it is considered the least invasive disc surgery. Theoretically, this minimally invasive technique should be suitable for elderly patients who have comorbidities. However, such elderly patients usually also have foraminal stenosis due to facet hypertrophy, which makes the procedure technically demanding. Here, we have reported three cases of patients aged over 65 years who underwent PED. We first performed foraminoplasty using a highspeed drill and inserted an 8 mm cannula safely through the enlarged foramen. In all cases, the herniated fragments of the nucleus pulposus were successfully removed endoscopically under local anesthesia without any surgery-related complications. In all patients, low back and leg pain improved immediately postoperatively. In conclusion, even in elderly patients with foraminal stenosis, PED can be safely performed by utilizing the foraminoplasty technique. For elderly populations with severe comorbidities, this technique is expected to be especially useful.

Author(s):

Koichi Sairyo

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