Incisions were made paraspinally. Soft tissues were dissected down to facet joints at L3-L4, L4-5 and L5-S1 under continuous direct visualization with the use of an endoscope. an incision was made around the guidewires, the dilators were placed over the guidewires into the disc space. Working tubes were placed over the dilators into the disc space. The guidewires and the dilators were removed. The guidewires and dilators were removed. Attention was turned to the left side L3-L4 the disc space was inspected. A discectomy was performed under endoscopic continuous visualization. This was carried back to the annulus, the tube was withdrawn back into the foramen, and the exiting and tranversing nerve roots were identified and found to be free of extrinsic pressure and protected throughout the case. The tub was then replaced back into the disc space. an annuloplasty was achieved utilizing the Ellman probe, over the anterior posterior medial and lateral annulus. The tubes were withdrawn from L3-L4 disc space. The disc and epidural space was explored. Same procedure was performed at L4-L5 and L5-S1. Incisions were irrigated out well and closed using 0 Vicryl and 3-0 Monocryl for superficial dermal, the epidermis was sealed with dermabond.

Thanks