A New Percutaneous Endoscopic Instrument for Far-migrated Disk Herniation: A Retrospective Single-Institution Study.

OBJECTIVE:Compared with the traditional posterior approach, the transforaminal (TF) approach for percutaneous endoscopic lumbar diskectomy (PELD) in patients with disk herniation has a limited resection range that is problematic to treat far-migrated disk herniation. This study examined the usefulness of a newly developed percutaneous endoscopic instrument for far-migrated disk herniation. METHODS:This retrospective study included 22 patients with migrated disk herniation ≥ 10 mm who underwent transforaminal PELD using the new instrument between August 2014 and May 2017. The new instrument differs from conventional forceps because it has only one jaw that rotates in a plane perpendicular to the mouth opening. The migrated herniated disk is held between the instrument and bone surface, pulled out, and subsequently removed using conventional forceps. RESULTS:Herniated disks that had migrated up to 16 mm were removed successfully in all patients. CONCLUSIONS:The new instrument is a useful tool that can expand the resection range of the TF approach for PELD.