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Mr of ths case. Access to disc. COURSE OF WORKING CANNULA. QUADRATUS LUMBORUM. MULTIFIDUS. LONGISSIMUS. INTERSPINALIS. ILIOCOSTALIS. PSOAS MAJOR. Transforaminal surgery. midline. Disc space as is seen. Lateral marking. Lateral c arm. Lordosis considered. Same distance from midline. - PowerPoint PPT Presentation
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Mr of ths case
Access to disc
COURSE OF WORKING CANNULA
INTERSPINALIS
MULTIFIDUS LONGISSIMUSILIOCOSTALIS
QUADRATUS LUMBORUM
PSOAS MAJOR
Transforaminal surgery
midline
Disc space as is seen
Lateral marking
Lateral c arm
Lordosis considered
Same distance from midline
Point of entry
LA
Needle trajectory
AP
Lateral
On entry ap
On entry LAT
Guide wire ready
Remove needle
Dialtor over guide wire
Dilator at intertrans area
Dilator in disc centre ap
Dilator in disc lat
Cannula on dialtor
Cannula in disc below fragment
Cannual seen in lateral
Scope and grasper in cannula
First glimpse
Removal of herniation
fragment
Grasper seen on c arm
Skin cut less than 8 mm
System USP
• Size• Ease of use• Minimalism in instruments• Evolution and version 3
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