Uniportal Endoscopic Surgery for Thoracolumbar Junction Disc Herniation in a Patient With Myelopathy: A Technical Note and Surgical Video

Thoracolumbar junction pathologies can be treated through various anterior and posterior approaches. In recent decades, minimally invasive endoscopic procedures, including percutaneous endoscopic transforaminal discectomy (PETD), have emerged to reduce tissue disruption and iatrogenic instability. This surgical video describes the steps required to perform PETD and highlights the importance of optimal preoperative planning. A 47-year-old male patient with a T12–L1 disc herniation in the left paracentral and foraminal region, compressing the spinal cord, was treated with PETD. Under fluoroscopic guidance, precise skin markings were made, followed by sequential placement of the needle, guidewire, dilator, and working cannula using an inside-outside technique. The advantages and limitations of this approach were described. Successful removal of the herniated fragment and associated osteophyte was achieved using PETD. The patient’s pain decreased abruptly after surgery and fully resolved in the medium term. The patient ambulated independently 1 month after the procedure. PETD is a safe and efficient alternative for treating thoracolumbar junction pathologies in patients with disc herniation and/or myelopathy caused by neural compression. This fully endoscopic technique can achieve ventral decompression even under sedation.