Arthroscopic-assisted uniportal spinal surgery with bone-anchored annular repair for far lateral lumbar disc herniation: A case report.

Authors

Hao Cao, Xin Zhang, Shili Chen, Dong Liu, Fei Sun, En Song

Published in

Medicine. Volume 105. Issue 42. Pages e51107. Oct 16, 2026.

Abstract

Far lateral lumbar disc herniation (FLLDH) is technically challenging because of its foraminal or extraforaminal location. Arthroscopic-assisted uniportal spinal surgery (AUSS) with bone-anchored annular repair has previously been described for lumbar disc herniation, but its use through an extraforaminal corridor for FLLDH has not been specifically detailed.
A 50-year-old woman presented with a 4-month history of refractory lumbosacral and gluteal pain, followed by acute right lower-extremity radicular pain along the L3-L4 dermatome. Walking was limited to <20 minutes. Her leg-pain visual analog scale (VAS) score was 7, and her Oswestry Disability Index (ODI) was 45/50 (90%) despite conservative treatment.
Computed tomography and magnetic resonance imaging demonstrated a right-sided far-lateral L3-L4 disc herniation with foraminal stenosis and compression of the exiting L3 nerve root. Dynamic radiographs showed no segmental instability.
The patient underwent AUSS-assisted far lateral discectomy under general anesthesia through a 1.5 to 2.0-cm extraforaminal incision. Foraminal decompression, removal of the herniated nucleus pulposus, and bone-anchored annular repair were performed through the same uniportal approach.
The operation lasted 45 minutes, with an estimated blood loss of approximately 10 mL. No perioperative complications were documented. The leg-pain VAS score decreased from 7 to 1, and the ODI decreased from 45/50 (90%) to 10/50 (20%). Postoperative day 1 imaging confirmed removal of the herniated fragment and adequate decompression of the exiting L3 nerve root. At the 15-month telephone-only follow-up, the patient-reported leg-pain VAS score was 0 and the ODI was 8/50 (16%); no physical examination or interval imaging was obtained.
This case demonstrates the technical feasibility of performing decompression and bone-anchored annular repair for FLLDH through an extraforaminal AUSS corridor. The contribution is the anatomical and procedural application of a previously described repair concept rather than the introduction of a new repair technique. Because the 15-month follow-up was telephone-based and lacked neurological examination and interval imaging, this report does not establish structural healing, recurrence prevention, long-term safety, comparative effectiveness, or superiority.

PMID:
42888534
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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