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Endoscopic Foraminoplasty-Assisted Annulus Fibrosus Repair for Lumbar Disc Herniation in a Patient with Nerve Root Variation: A Case Report from Xi’an Ninth People’s Hospital
Date：2025-09-08 Read：
Endoscopic Foraminoplasty-Assisted Annulus Fibrosus Repair for Lumbar Disc Herniation in a Patient with Nerve Root Variation: A Case Report from Xi’an Ninth People’s Hospital
The Department of Orthopedics at Xi’an Ninth People’s Hospital recently performed a successful endoscopic foraminoplasty-assisted discectomy combined with annulus fibrosus repair in a patient presenting with lumbar disc herniation complicated by nerve root variation. The procedure not only relieved the patient’s symptoms but also restored spinal structural integrity and function.
A patient presented with right lateral lower leg and lateral plantar pain and numbness, accompanied by low back pain, for one month. Symptoms were exacerbated by activity and only partially relieved at rest. Initial evaluation at an external clinic suggested lumbar spinal stenosis, prompting admission to our hospital. Imaging studies revealed straightening of lumbar lordosis, mild osteophyte formation, L3–L4 and L4–L5 disc bulges, and L5–S1 disc herniation. Thickening and calcification of the posterior longitudinal ligament resulted in secondary compression of the dural sac, correlating with the patient’s clinical symptoms.
After careful evaluation, Director Martin and Dr. Bingchen Dong of the Orthopedic Department determined that the patient would benefit from L5–S1 endoscopic foraminoplasty-assisted discectomy and annulus fibrosus repair. Intraoperatively, multiple nerve root variations were identified, significantly increasing surgical complexity and the risk of iatrogenic nerve injury. Leveraging extensive clinical experience and advanced technical skills, the surgical team successfully performed nucleus pulposus removal and annulus repair, achieving symptomatic relief, morphological restoration, and functional reconstruction simultaneously.
Postoperatively, the patient reported significant relief from leg numbness and low back pain, demonstrating rapid functional recovery. This case illustrates the feasibility and safety of endoscopic foraminoplasty-assisted annulus fibrosus repair in patients with complex anatomical variations. Key factors contributing to success included thorough preoperative imaging assessment, meticulous intraoperative technique, and precise postoperative care.
The successful completion of this procedure highlights the Department of Orthopedics at Xi’an Ninth People’s Hospital’s capability in performing advanced minimally invasive spinal surgery for challenging cases. Endoscopic foraminoplasty-assisted annulus fibrosus repair provides a comprehensive approach that addresses both symptom relief and structural restoration, even in the presence of nerve root anomalies.
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