BESS Issue 3. | Page 4

CONTRA-LATERAL APPROACH Use the advantage of free handing of visual direction. You can go anywhere In the water. Deep breath and keep going ! Ground Plans An exiting root can be compressed at the foramen due to foramina LDH and/or foramina stenosis for severe collapsed disc space with hypertrophied LF and spur of superior articular process. To access the foramen, there are two ways. One is contralateral approach with a long way but familiar circumstance and the other is far-lateral approach with a short way but unfamiliar views for relatively few cases. In this issue, we are going to see the contralateral approach first. To reach the contralateral exiting root, ipsilateral distal side of the lamina, base of spinous process, contralateral upper, inferior side of the lamina should be removed first to make working space enough for an endoscope and a certain instru4 InU’rMind 1. Rt. sided inlets are lower and lateral about 5mm than the Lt.sided inlets. 2. Make enough working space in the second base camp 3. After bony preparation by burring is finished, LF should be removed. ment to reach the foramen across the midline and then foraminal site could be explored(Issue 2). At foramen, the roof overhanging the pedicle, foraminal LF and superior tips of superior articular process should be removed more than mid-level of the disc space and clearly inspect the exiting root.