Male 49 yo with left side back pain, MRI revealed lumbal herniated disc . Incision is paramedian left side. And straight muscle disection until reach the bone (lamina). After level confirmation with the help of C arm, disection were extended to revealed L4 -5 facet. A 5mm rosen burr used to thin the lamina and half of facet - medial part. When ligamentum flavum had been encountered, the burr changed to diamond type. Irrigation was continuous to prevent heat injury. Using retractor, lumbar spinal ws brought to medial. And discus were incised then removed peacemeal. Finalize with irrigation, steroid, and skin stitches.
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