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Automated percutaneous discectomy at the L5-S1 level. Use of a curved cannula.

Previously, a major limitation to percutaneous disc decompression to relieve symptoms of sciatica was the inability to approach the L5-S1 level. Obstruction by the iliac crest prevented the instrumentation from entering the L5-S1 disc space. In this paper, the authors describe a curved cannula which can be placed down to the L5-S1 disc space over a straight trocar that has been anchored at the annulus. The cannula bends the flexible aspiration probe back into the plane of the disc so that it is no longer obstructed by the sacral end plate. Using this system, the L5-S1 disc space was successfully removed in 90% of 30 cases.