Jim Yue, MD

Jim Yue, MD

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Patient selection is critical to the success of any surgical approach, the herniated disc tissue must be accessible through the foramen. Patient is positioned in the prone position on either bolsters or a Wilson frame to open up the foraminal space. AP and Lateral radiographs are used to identify the targeted foraminal levels. If an intra-discal approach is elected, an 18 gauge spinal needle is initially introduced not past the medial edge of the pedicle AP view, and in the posterior 3rd of the disc space in the lateral view with care being taken to avoid the exiting nerve root. The guide wire is transferred through the needle and a stab incision is performed along the guide wire. The dilator is introduced over the guide wire to the level of the annulus, again care should be taken to avoid the exiting nerve. The beveled cannula is introduced over the dilator creating a working portal for the introduction of the endoscope for direct visualization, light, irrigation and working access to the previously identified pathology. Upon completion of the surgery, the small wound can be closed with either steri-strips or a single stitch.

Jim Yue, MD
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