Percutaneous endoscopic lumbar discectomy in calcified herniated disc L5-S1

Abstract

Calcified lumbar intervertebral disc herniation is a special type of herniated disc. Chronic inflammation is proposed to be a possible cause of calcification. Calcification can occur in the herniated nucleus pulposus when the course of lumbar disc herniation has been more than six months.

A hernia or hernial material diminishes the lumen of the vertebral canal causing stenosis and compression in the nervous tissue. Most patients will require open, traditional, or microdiscectomy surgery for subsequent decompression.

Percutaneous endoscopic lumbar discectomy is a minimally invasive technique that is used for excision of herniated discs without damaging healthy tissue, improving the postoperative and reducing the risk of nerve injury.

Case Presentation: 34 years old male patient, police on active duty, with a traumatic history on the lumbar spine four years ago, which causes severe low back pain according to the Pain Scale (VAS) of 9 and the Oswestry Disability Index of 56% , dysbasic gait with left lower limb lameness, decreased muscle strength for left foot dorsiflexion 4/5 and anesthesia in L5 dermatome.

Magnetic resonance imaging shows a large left foraminal paracentral extrusion type hernia with severe narrowing of the canal. Percutaneous endoscopic lumbar discectomy allows minimally invasive techniques to decompress the medullary canal despite having a significant narrowing. Likewise, it does not destroy healthy tissue unnecessarily or sacrifice stability. Finally, a lower incidence of complications is reported, both nervous, vascular, soft tissue injury, infectious, among others.