Nicholas Prada, MD

Nicholas Prada, MD

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The interlaminar window at L5-S1 is easily accessed through a direct posterior approach, visualized using both AP and Lateral radiographs. The lateral facet is located and the stab incision is made directly medial to the facet to the level of the fascial layer. The dilator is introduced to the level of the ligamentum flavum, confirming AP and Lateral radiographs. The cannula is introduced over the dilator with the bevel open medially and the endoscope is introduced. Various instruments including the Trigger-Flex® RF probe are used to expose the ligamentum flavum. Punches and kerrisons can now be used to perforate the ligamentum for access to the spinal canal. The nerves are visualized and mobilized using a dissector. The canula is rotated to further mobilize, retract and protect the nerves exposing the herniation. A variety of instruments along with the Trigger-Flex® RF probe can now be utilized to remove disc material. The small wound site can be closed with minimal suture or steri-strips.

Nicholas Prada, MD
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