ABSTRACT
This chapter discusses the development, techniques, patient selection, outcomes, and complications associated with automated percutaneous lumbar discectomy. Patients with leg symptoms greater than back pain are better candidates than those with primarily axial symptoms. In addition, a minimum six-week course of nonoperative treatment should be attempted. In addition to the physician/surgeon, an anesthetist, a scrub nurse, a circulating nurse and a radiology technician will need to be present. A small skin incision is made at the proposed entry site and the guide needle is inserted slowly through the low back musculature. Under fluoroscopic guidance in the lateral view, a long spinal needle is used to give local anesthesia and advance in the trajectory of the L5–S1 disc. Automated percutaneous lumbar discectomy has been shown to be effective and safe in the management of patients with contained herniated lumbar discs.
