LAPAROSCOPIC LUMBAR DISKECTOMY

BACKGROUND: Minimally invasive spine surgery is gaining popularity. Re sults of currently used percutaneous posterior techniques fall short o f standard open microdiscectomy. Using a posterior percutaneous techno logy with an anterior laparoscopic approach may improve results and st ill maintain the advantages of a minimally invasive procedure. METHODS : Patients with symptomatic lumbar protruded discs confirmed by comput ed tomography or magnetic resonance imaging were offered the procedure . Transperitoneal visualization of the retroperitoneum was supplemente d with fluoroscopic guidance. A small window made to the disc allowed the percutaneous nucleotome to be inserted through the anterior annulu s. The automated nucleotome aspirated the nucleus, leaving the ligamen ts intact. RESULTS: All patients underwent successful dissection and p lacement of the nucleotome. Of the 23 patients, 21 left the hospital i n less than 24 hours. The initial neurologic outcome is that 20 out of the 23 patients had improved symptoms or were asymptomatic. Complicat ions were minimal. CONCLUSION: Laparoscopic lumbar discectomy is safe, and for carefully selected patients, can be an alternative to posteri or microdiscectomy.