Two-level percutaneous endoscopic lumbar discectomy for highly migrated upper lumbar disc herniation: A case report

Figure 1 Preoperative and postoperative imaging examination. A, B, C, D: Preoperative dynamic imaging x-ray examination indicated instability of the L4/5 vertebral body; E, F: Preoperative magnetic resonance imaging revealed L2/3 disc herniation with the nucleus pulposus highly migrating upward to the upper margin of the L2 vertebral body; G, H: Postoperative magnetic resonance imaging examination revealed clean removal of the nucleus pulposus.

Figure 2 Surgical procedure of two-level percutaneous endoscopic lumbar discectomy. A, B, C: Working channels placed into the intervertebral foramen at L1/2 and L2/3 level; D, E: Intraoperative endoscopic images of L1/2 and L2/3: complete removal of the nucleus pulposus; F: Removal of nucleus pulposus tissues.