Modified Endoscopic Access for Migrated and Foraminal/Extraforaminal Disc Herniation

Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive spinal technique that has several advantages over open discectomy, including less paravertebral muscle injury, preservation of bony structure, and rapid recovery. PELD has gained popularity for removal of herniated disc (HD) material over the past few years since Kambin introduced the percutaneous posterolateral approach in 1983. Remarkable evolution of endoscopic techniques and instrumentation leads to successful outcomes comparable to conventional open surgery. PELD has been applied to various types of disc herniation and the indication has been expanded. I propose various strategies for PELD according to various types of disc herniation.