Minimally invasive treatment of far lateral lumbar disc herniation: Selective nerve root block with percutaneous transforaminal endoscopic discectomy

Figure 4 A typical case of selective nerve root block combined with percutaneous transforaminal endoscopic discectomy for treating far lateral lumbar disc herniation. A56-year-old man was admitted to the hospital with radiating pain in his leftlower limb for 3 months. The diagnosis was far lateral lumbar disc herniation, and the responsible segment and nerve root were the L4/5 and L4 nerve roots. A: The X-ray positive and lateral position of the lumbar spinebefore operation; B: The X-ray hyperextension and flexion position of thelumbar spine before operation; C and D: Magnetic resonance imaging and computed tomography before the operation; E and F: The patients undergoing selective nerve root block before surgery; G and H: X-raypositive and lateral images of channel placement during percutaneous transforaminal endoscopic discectomy operation; I: The microscopic images of the outlet nerve root, walking nerve root and intervertebral space during theoperation; J: The outlet nerve root after decompression; K: The walking nerve heel afterdecompression; L: The nucleus pulposus tissue removed during the operation.