Procedure: Left sided L3-L4, and L4-L5 invasive tubular discectomy.
Patient placed prone on a Wilson frame, arms were protected, all bony prominences were carefully padded, low back was prepped and draped in usual sterile fashion, a needle was placed in the L3-L4 disc space from approximately 45 degrees oblique, a discogram was done using Isovue and Isogreen and showed a clear tear in the L3-L4 disc with extensive dye spread, next, a percutaneous small incision was made over the needle, A guidewire was placed in the L3-L4 disc space and dilating tube was placed into guidewire was placed in the L3-L4 disc space and dilating tube was placed into the L3-L4 disc space. Next pituitary rongeur was used to create a far lateral discectomy at L3-L4, Multiple fragments of disc material were removed. An electrocautery was used to cauterize the annulus and the disc. A 40mg of Depo Medrol as well as Marcaine were injected into the disc and the dilating tube was removed. Next the exact same procedure was done at L4-L5 via separate incision. Wounds were copiously irrigated. Both the two wounds were closed using a nylon suture.