2021 Volume 12 Issue 7 Pages 966-972
Introduction: We previously reported using an internal retractor for percutaneous full-endoscopic posterior discectomy of the cervical spine. The internal retractor is useful in areas with narrows safety margins, such as the cervical spine. On the other hand, in the lumbar spine, the internal retractor is also useful for placing the outer sheath onto the intervertebral disc.
Methods: Percutaneous full-endoscopic posterior discectomy using an internal retractor was performed for cases with cervical or lumbar disc herniation.
Results: A total of 14 cases (7 cases of cervical spine and 7 cases of lumbar spine) were studied. In all cases, the hernia could be resected while maintaining a proper visual field, and there was no postoperative neuropathy.
Conclusions: Unlike the conventional spatula or dissector, the internal retractor surface can be inserted at the outermost area and safe retraction of the nerve root can be performed by just rotating the instrument and the scope. Moreover, it is possible to operate with forceps or a bipolar coagulator while protecting the nerve root securely with the internal retractor and observing it. A two-step nerve root retraction with an internal retractor and an outer sheath can be performed safely because of a smaller gap with the outer sheath than with a conventional dissector and spatula. Due to these unconventional characteristics, the internal retractor contributes to the safety and facility of percutaneous full-endoscopic posterior discectomy in the whole spine.
