Full-endoscopic discectomy utilizing an interlaminar approach for gas-containing herniation at L5–S1

Abstract

Intradiscal gas is frequently observed in older patients with disc degeneration and can occasionally result in nerve root compression. A 79-year-old male patient presented with increasing left lower extremity sciatica. Lumbar computed tomography (CT) and magnetic resonance (MR) images revealed a left paramedian L5–S1 gas-containing disc herniation. Utilizing an interlaminar approach, a full-endoscopic discectomy (FED) was performed at L5–S1. During disc removal, we countered intradiscal gas bubbles. Postoperatively, the patient’s symptoms/signs fully resolved, and follow-up MR and CT images revealed total resection of the disc herniation, and no further gas. Through an interlaminar FED, we effectively removed an L5–S1 MR/CT-documented gas-containing disc herniation.