Table of Contents
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General:
Preface
List of Contributors
Lumbar Endoscopy: Historical Perspectives, Present & Future
Abstract
INTRODUCTION
THE TRANSFORMATION
HISTORY PERSPECTIVES OF ENDOSCOPIC SPINAL SURGERY
THE NITZE-LEITER MUSEUM FOR ENDOSCOPY
THE EVOLUTION OF LASERS IN SPINAL ENDOSCOPY
RADIOFREQUENCY ABLATION
NEW LANDMARK CLINICAL OUTCOME STUDIES
THE ASIAN LEADERSHIP ROLE
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Endoscopic Lumbar Discectomy – Anatomy, Indications and Techniques
Abstract
INTRODUCTION
ANATOMICAL CONSIDERATIONS
Anatomical Classification of Percutaneous Endoscopic Approach (Fig. 1) [27]
Types of Percutaneous Endoscopic Lumbar Discectomy System Working Channel (Fig. 3)
DIAGNOSIS
PREPARATION
Set-up
Position
ANESTHESIA
< Anesthetic Methods for Percutaneous Endoscopic Lumbar Discectomy >
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Patient Reported Outcome Measures, Nomenclature & Classifications in Clinical Research of Endoscopic Spine Surgery
Abstract
INTRODUCTION
WIDELY USED CLINICAL OUTCOME TOOLS
MINIMAL CLINICALLY IMPORTANT DIFFERENCE SCORE
ENDOSCOPIC CLASSIFICATION OF STENOSIS
THE NOMENCLATURE MAZE
LUMBAR DISEASE CLASSIFICATION FOR ENDOSCOPIC SPINE SURGERY
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFEERENCES
Transforaminal Percutaneous Endoscopic Lumbar Discectomy
Abstract
INTRODUCTION
INDICATIONS AND APPLICATIONS
1. Common Indications for Percutaneous Endoscopic Lumbar Discectomy
2. Indications for Difficult Cases of Percutaneous Endoscopic Lumbar Discectomy
1. General Structural Anatomy: Posterolateral PELD Approach
2. General Operative Anatomy: Posterolateral PELD Approach
Operative Anatomical Structures in PELD
3. Special Operative Anatomy: Posterolateral PELD Approach
4. Exiting Nerve Root Approach
5. Traversing Nerve Root Approach
6. Operative Safety Zone Anatomy
7. SURGICAL PITFALLS
7.1. Position of the Working Cannula
7.2. Anatomical Limitation
• Foraminal Space
• Iliac Crest
8. Accessible Surgical Access Area
9. Techniques for an Inferior Migrated Disc
9.1. Epidural Exposure
9.1.1. Extreme Lateral Approach [2]
9.1.2. Suprapedicular Approach
9.1.3. Foraminoplastic Technique
9.1.4. Contralateral approach [45]
9.2. Entry Point
9.2.1. MRI Length Measurement Method
9.2.2. MRI Marker Method
10. Intraoperative Examination Method
11. PROCEDURAL STEPS
11.1. Positioning & Skin Marking
11.2. Skin Incision & Anesthesia
11.3. Needle Insertion & Provocative Chromodiscography
11.4. Guide Needle Insertion
11.5. Evocative Chromodiscography
11.6. Working Cannula Insertion
11.7. Working Cannula Placement
11.7.1. Outside-In Approach
11.7.2. Inside-Out Approach
11.8. Decompressive Discectomy
11.8.1. Foraminal Work
11.8.2. Annulus Fenestration
11.8.3. Discectomy
11.9. Assessing the Decompression
11.9.1. Exiting Root Approach
11.9.2. Epidural Central Approach
11.9.3. Epidural Inferior Approach
11.9.4. Major Concerns in the PELD for Inferior Migrated Disc
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Structural Preservation Interlaminar Endoscopic Lumbar Discectomy (IELD) For L5-S1 Herniated Disc
Abstract
INTRODUCTION
ANATOMY & RATIONALE
THE CONCEPT OF V-POINTS
PRESERVATION OF THE MOTION SEGMENT
SURGICAL STEPS
Ipsilateral Discectomy Technique
Indications
Anaesthesia
Position
Discography
Skin Incision & Markings
Docking of Working Channel and Endosope
Splitting of Lgamentum Flavum
Discectomy
Annular Sealing
Skin Closure
Contraleteral Discectomy Technique
Indications
Anaesthesia
Position
Discography
Skin Incision & Markings
Docking of Working Channel and Endoscope
Ligamentum Flavum Splitting
Discectomy
Annular Sealing
Skin Closure
POTENTIAL RISKS
Dural Tear
Incomplete Discectomy
Nerve Root Injury
Epidural Hematoma
Infection
Recurrence
Less Common Complications
POSTOPERATIVE AND REHABILITATION PROTOCOL
CLINICAL SERIES
DISCUSSION
TECHNICAL PEARLS
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Hybridized Inside-Out/Outside-In Approach for Treatment of Endstage Vacuum Degenerative Lumbar Disc Disease
Abstract
INTRODUCTION
TECHNIQUE DESCRIPTION
1. Preoperative Planing
2. Patient Positioning
3. Access Planning and Marking
4. Local Anesthesia & Monitored Anesthesia Care (MAC) Sedation
5. Placement of the Working Cannula
6. Initial Foraminoplasty
OUTSIDE-IN PORTION
7. Pain Generators in the Epidural Space
8. Target the Center of the Disc Space
INSIDE-OUT PORTION
9. Discectomy
10. Intradiscal Assessment of Painful Pathology
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Full Endoscopic Interlaminar Contra-Lateral Lumbar Foraminotomy
Abstract
INTRODUCTION
SURGICAL ANATOMY
SURGICAL INDICATIONS
CONTRAINDICATIONS
SURGICAL TECHNIQUE
Preoperative Planning
Anaesthesia
Patient Preparation & Position
Surface Marking & Docking
Contralateral Approach
Foraminal & Extraforaminal Decompression
Final Check
Postoperative Protocol
CLINCIAL SERIES
COMPLICATIONS AND AVOIDANCE
Intraoperative Bleeding
Dural Tear & Nerve Injury
Incomplete Decompression
Recurrence
Iatrogenic Instability
Infection
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Mobile Outside In, SCOT (Suprapedicular Circumferential Opening Technique) Approach for Highly Inferior Migrated HNP
Abstract
INTRODUCTION
RATIONALE FOR SCOT
SURGICAL STEPS
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Over-The-Top versus Transforaminal Lumbar Endoscopic Techniques
Abstract
INTRODUCTION
TRANSFORAMINAL APPROCHES
INSIDE-OUT TECHNIQUE
OUTSIDE-IN TECHNIQUE
FROM INTERLAMINAR TO OVER-THE-TOP TECHNIQUES
UNILATERAL AND BILATERAL ENDOSCOPIC OVER THE TOP TECHNIQUES
OVER-THE-TOP LUMBAR DECOMPRESSION FOR CENTRAL CHANNAL STENOSIS
OVER THE TOP SURGICAL TECHNIQUE
PATIENT SELECTION PROTOCOLS FOR LUMBAR SPINE DECOMPRESSION
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Endoscopic Treatment of Lumbar Facet Cysts
Abstract
INTRODUCTION
ETIOLOGY
CLINICAL COURSE
DIFFERENTIAL DIAGNOSIS
NON-OPERATIVE CARE
INTERVENTIONAL PROCEDURES
SURGICAL TREATMENT
ENDOSCOPIC MANAGEMENT
Transforaminal Approach
Interlaminar Approach
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Transforaminal Endoscopic Lumbar Foraminotomy TELF for Lumbar Stenosis in Patients Aged Over 80 Years
Abstract
INTRODUCTION
RADICULOPATHY
TRANSFORAMINAL ENDOSCOPIC LUMBAR FORAMINOTOMY
TELF EVOLUTION
TELF INDICATIONS
ADVANTAGES AND DISADVANTAGES OF TELF
SURGICAL TECHNIQUE
TELF POSTOPERATIVE CARE
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Safety and Effectiveness of the Endoscopic Rhizotomy for the Treatment of Facet-Related Chronic Low Back Pain
Abstract
INTRODUCION
ANATOMICAL BASIS FOR ANTERIOR & POSTERIOR COLUMN DENERVATION
DIAGNOSTIC BLOCKS AS PROGNOSTICATOR OF OUTCOME
RADIOFREQUENCY RHIZOTOMY
ENDOSCOPIC FACET DEINNERVATION
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Visualized Endoscopic Radiofrequency Ablation of Sinuvertebral Nerve and Basivertebral Nerve for Chronic Discogenic Back Pain
Abstract
INTRODUCTION
RATIONALE
Pathoanatomical and Pathophysiological Considerations of Degenerated Lumbar Intervertebral Disc Structural Degeneration
Inflammatory Cascade, Neuronal Sensitization and Pathologic Neuronization of the Disc
Anatomy of Sinuvertebral Nerve and Basiverebral Nerve (BVN)
Current Radiofrequency Ablation Approaches For Denervation
Diagnostic Procedure For Candidates Suitable For Radiofrequency Ablation Of Pathological Nerves
Anesthesia and Positioning
SURGICAL STEPS
Transforaminal Approach
Interlaminar Approach
Thermal Shrinkage Of Bulging Degenerative Disc.
Skin Closure And Postoperative Rehabilitation Protocol
Key Feature Of Radiofrequency Ablation Technique
POTENTIAL RISKS
CLINICAL SERIES
DISCUSSION
TECHNICAL PEARLS
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Endoscopic Resection of Schwannoma in the Psoas Major Muscle
Abstract
INTRODUCTION
EXEMPLARY CASE
SURGICAL PROCEDURE
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Endoscopic Uninstrumented Transforaminal Lumbar Interbody Fusion with Allograft for Surgical Management of Endstage Degenerative Vacuum Disc Disease
Abstract
INTRODUCTION
POSITION, ANESTHESIA & ACCESS PLANING
PEARLS OF THE SURGICAL TECHNIQUE
CLINICAL SERIES
FUSION ASSESSMENT
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Full Endoscopic Endplate Decortication and Vertebral Mobilization Technique of Transforaminal Lumbar Interbody Fusion for Degenerative Spondylolisthesis
Abstract
INTRODUCTION
RATIONALE
Anatomical Considerations During Endo-TLIF Surgery
Direct Bilateral and Contralateral Decompression of Central Spinal Canal and Nerve Roots with Endo-TLIF
Concepts of Full Endoscopic Adhesion Releasing Technique with Endoscopic Drill
Concepts of Full Endoscopic Endplate Denudation Technique
Concepts of Large-sized Interbody Cage Insertion Using the Harrison Cage Glider
Reduction of the Spondylolisthesis and Correction of the Focal Scoliosis by Endo-TLIF
SURGICAL STEPS
Preoperative Preparation
Anesthesia and Skin Incision
Insertion of Endoscope
Surgical Procedures
Pedicle Screw and Rod Insertion with Appropriate Compression and Distraction
Post-Operative Care
Potential Risks
CLINICAL SERIES
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENT
REFERENCES
Technical Pearls for Difficult Cases, Controversies and Complications of Lumbar Endoscopy
Abstract
INTRODUCTION
1. Early Recurrence
2. Vascular Injury
3. Neural Injury
4. Infection
CASES EXAMPLES
1. Paracentral Lumbar HNP
2. Upward Migrated Lumbar HNP
3. Foraminal Lumbar HNP
4. Far Lateral Lumbar HNP
5. Severe Canal Compromise Type Lumbar HNP
6. Severe Canal Compromised, Epidural Migrated Lumbar HNP
7. Downward Migrated Lumbar HNP
8. Recurred HNP After Open Lumbar Discectomy
9. Recurrent HNP After Transforaminal PELD
10. Recurrent HNP after Intradiscal Therapy
11. Focal Calcification within Lumbar HNP
12. Combined Foraminal Stenosis and HNP
13. Discal Cyst
14. Two-level Lumbar HNP
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Treatment of Degenerative Lumbar Spondylolisthesis with Endoscopic Decompression of the Lumbar Spinal Canal
Abstract
INTRODUCTION
CASE PRESENTATIONS
Case 1
Case 2
DISCUSSION
CONCLUSION
CONSENT FOR PUBLICATION
CONFLICT OF INTEREST
ACKNOWLEDGEMENTS
REFERENCES
Contemporary Endoscopic Spine Surgery
(Volume 2)
Lumbar Spine
Edited by
Kai-Uwe Lewandrowski
Center For Advanced Spine Care
Tucson
Arizona
USA
Jorge Felipe Ramírez León
Fundación Universitaria Sanitas
Clínica Reina Sofía – Clínica Colsanitas
Centro de Columna – Cirugía Mínima Invasiva
Bogotá, D.C.
Colombia
Anthony Yeung
University of New Mexico
School of Medicine
Albuquerque
New Mexico
Hyeun-Sung Kim
Department of Neurosurgery
Nanoori Gangnam Hospital
Seoul
Republic of Korea
Xifeng Zhang
Department of Orthopedics
First Medical Center
PLA General Hospital
Beijing 100853
China
Gun Choi
Neurosurgeon and Minimally Invasive Spine Surgeon
President Pohang Wooridul Hospital
South Korea
Stefan Hellinger
Department of Orthopedic Surgery
Arabellaklinik
Munich
Germany
Álvaro Dowling
Endoscopic Spine Clinic
Santiago
Chile
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Preface
Nowadays, lumbar spinal endoscopy is well accepted. Not too long ago, its critics scrutinized it for lack of sufficient high-grade clinical evidence to endorse the implementation of endoscopic spinal surgery protocols to treat the common painful conditions of the lumbar spine. Traditionally trained spine surgeons still heavily rely on image-based medical necessity criteria for surgical intervention. These include stenosis, deformity, and instability. In essence, endoscopic spinal surgery replaces these established open lumbar spinal surgery protocols with more targeted miniaturized surgeries that largely ignore these traditional image-based criteria when establishing the indication for surgery. Instead, it focuses on treating validated pain generators, many of which escape detection by conventional advanced imaging studies such as the magnetic resonance image (MRI) scan. It is undeniable even to the untrained bystander that this amounts to a culture clash.
Contemporary Endoscopic Spine Surgery: Lumbar Spine's editors are internationally renowned key opinion leaders with decades of experience in endoscopic spinal surgery. They have come together to develop a multi-authored and clinically focused medical monograph to give the reader a most up-to-date review of modern lumbar spinal endoscopic surgeries. Moreover, they intended to disperse the myth of endoscopic lumbar spine surgery being experimental - a procedure that can only be consistently be mastered by the talented few. Therefore, the editors asked the contributing authors to illustrate their results with the endoscopic lumbar surgery in the context of the peer-reviewed literature by thoroughly discussing the available high-grade clinical evidence. The editors have authored many of these landmark articles that pushed the envelope of clinical research far beyond the initial level of personal opinion and case series reports. They went on to validate them with sophisticated statistical analysis of multi-arm clinical studies.
The publication is intended for Orthopedic Spine & Neurosurgeons interested in treating common painful conditions including herniated disc, stenosis, tumor, and infection with minimally invasive endoscopic techniques. The selection of chapters was based on contemporary trends in lumbar endoscopic spinal surgery. For this purpose, a wide array of highly timely and clinically relevant topics have been assembled based on historical and anatomical considerations. They range from the review of modern transforaminal and interlaminar decompression methods, their hybridized versions, the mobile outside-in approach for far-migrated disc herniations, the over-the-top and contralateral decompression techniques, endoscopic treatment of facet cysts, visualized rhizotomy procedures of painful facet disease, and other denervation techniques of the sinuvertebral- and basivertebral nerve, the application of endoscopic procedures in the elderly, to the illustrative discussion of challenging endoscopic indications and endoscopic and endoscopically assisted fusions. The editors identified these less costly yet safe endoscopic treatments for the lumbar spine's common painful degenerative conditions in response to patients' demand for less burdensome and less risky therapies with a shorter time to recovery and return to work. Contemporary Endoscopic Spine Surgery: Lumbar Spine was written with these goals in mind. The editors hope that the readers will find it an informative knowledge resource they will continue to revert to when implementing a lumbar endoscopic spinal surgery program in their practice setting.
Kai-Uwe Lewandrowski
Center For Advanced Spine Care
Tucson
Arizona
USA Jorge Felipe Ramírez León
Fundación Universitaria Sanitas
Clínica Reina Sofía – Clínica Colsanitas
Centro de Columna – Cirugía Mínima Invasiva
Bogotá, D.C.
Colombia Anthony Yeung
University of New Mexico
School of Medicine
Albuquerque
New Mexico Hyeun-Sung Kim
Department of Neurosurgery
Nanoori Gangnam Hospital
Seoul
Republic of Korea Xifeng Zhang
Department of Orthopedics
First Medical Center
PLA General Hospital
Beijing 100853
China Gun Choi
Neurosurgeon and Minimally Invasive Spine Surgeon
President Pohang Wooridul Hospital
South Korea Stefan Hellinger
List of Contributors
Anthony YeungUniversity of New Mexico School of Medicine, Albuquerque, New Mexico
Desert Institute for Spine Care, Phoenix, AZ, USAAn SixingDepartment of orthopedics, First Medical Center, PLA General Hospital, Beijing, 100853, ChinaÁlvaro DowlingEndoscopic Spine Clinic, Santiago, Chile
Department of Orthopaedic Surgery, USP, Ribeirão Preto, BrazilBu RongqiangDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, ChinaCarolina Ramírez MartínezMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C. Colombia, USACong QiangDepartment of Orthopedics Shenyang, Department of orthopedics, Shenyang 242 Hospital, Shenyang 110034, ChinaFriedrich TieberAm Webereck 6 1/2 - 86157 Augsburg, GermanyGabriel Oswaldo Alonso CuéllarMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C. Colombia, USAHarshavardhan Dilip RaoraneDepartment of Neurosurgery, Nanoori Hospital, Gangnam, South KoreaHyeun Sung KimDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, South KoreaIl-Tae JangDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, Republic of Korea, Beijing 100048, ChinaJin-Sung KimSpine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo Daero, Seocho-gu, Seoul, 137-701, KoreaJi-Yeon KimDepartment of Neurosurgery, Nanoori Hospital, Seoul City, South KoreaJiyeon KimDepartment of Neurosurgery, Nanoori Hospital, Gangnam, South KoreaJosé Gabriel Rugeles OrtízMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C. Colombia, USAJorge Felipe Ramírez LeónMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, Bogotá, D.C. Colombia, USA
Universidad El Bosque, Bogotá, D.C. Colombia, USAKai-Uwe LewandrowskiCenter for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA
Department of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil
Department of Orthoapedic Surgery, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia, USANicolás Prada RamírezMinimally Invasive Spine Center for Latinamerican Endoscopic Spine Surgeons, LESS Invasiva Academy, Bogotá, D.C. Colombia, USA
Colombia Clínica Foscal, Bucaramanga, Colombia, USANimar SalariDesert Institute for Spine Care, Phoenix, AZ, USANitin Maruti AdsulDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, South Korea
Ortho-Spine Surgery, Sir Ganga Ram Hospital, New Delhi, IndiaPang Hung WuDepartment of Neurosurgery, Nanoori Gangnam Hospital, Seoul, South Korea
Departments of Orthopaedic Surgery, National University Health System, Jurong Health Campus, SingaporeRamon TorresOrthopedic Surgeon/ Spine surgery fellowship Universidad de Chile Instituto Traumatologico Santiago, Chile, USARavindra SinghDepartment of Neurosurgery, Halifax Infirmary Hospital, Dalhousie University, CanadaRalf RothoerlDepartment of Neurosurgery, Isar Clinic, Munich, GermanyRômulo Pedroza PinheiroOrthopeadic Spine Surgery Department of Orthopedics and Anestesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto - SP, BrazilSaid G OsmanDepartment of Orthopedic and Spine Surgery, Arabellaklinik, Munich, GermanyStefan HellingerSky Spine Endoscopy Institute 1003 W 7th St, Frederick, MD 21701, USATae Jang ILDepartment of Neurosurgery, Nanoori Hospital, Gangnam, South KoreaWu ShangDepartment of orthopedics, Affiliated Hospital of Yangzhou University, Yangzhou, 225001, ChinaYan Yu-qiuDepartment of orthopedics, Beijing Yuho Rehabilitation Hospital, Beijing 100853, ChinaYuan HuafengDepartment of orthopedics Shenyang, Department of Orthopedics, Shenyang 242 Hospital, Shenyang 110034, ChinaZhang Xi-fengDepartment of Orthopedics, First Medical Center, PLA General Hospital, Beijing 100853, China
Lumbar Endoscopy: Historical Perspectives, Present & Future
Kai-Uwe Lewandrowski1,2,3,*,Jin-Sung Kim4,Friedrich Tieber6,Anthony Yeung
1 Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson AZ, USA
2 Associate Professor of Orthopaedic Surgery, Universidad Colsanitas, Bogota, Colombia, USA
3 Visiting Professor, Department Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil
4 Professor, Spine Center, Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea 222 Banpo Daero, Seocho-gu, Seoul, 137-701, Korea
5 Clinical Professor, University of New Mexico School of Medicine, Albuquerque, New Mexico Desert Institute for Spine Care, Phoenix, AZ, USA
6 Am Webereck 6 1/2 - 86157 Augsburg, Germany
Abstract
Endoscopy of the lumbar spine has traditionally found much broader adoption than those endoscopic procedures of other areas of the spine. Initially, a herniated disc was the target of endoscopic spine surgery techniques. Stenosis indications were later identified as technological advancements permitted. Many endoscopic spinal surgeries commenced in the domain of interventional pain management. Lasers and radiofrequency were applied to some of the procedures that nowadays are aided by direct videoendsocopic visualization of the painful pathology. In this chapter, the authors briefly reviewed the history of spinal endoscopy and its key opinion leaders. Giving credit to the most prominent pioneers of this fast-moving field sets the stage for what the reader is about to discover in this most-up-to-date publication: Contemporary Spinal Endoscopy: Lumbar Spine.
Keywords: Lumbar spine, disc herniation, stenosis, impingement, degeneration, decompression, open, minimally invasive, endoscopic, historical considerations, lasers, radiofrequency.
*Corresponding author Kai-Uwe Lewandrowski: Center for Advanced Spine Care of Southern Arizona and Surgical Institute of Tucson, Tucson, AZ, USA, Department of Orthopaedic Surgery, UNIRIO, Rio de Janeiro, Brazil and Department of Orthoapedic Surgery, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia, USA; Tel: +1 520 204-1495; Fax: +1 623 218-1215; E-mail:
[email protected]CONSENT FOR PUBLICATION
Not applicable.
CONFLICT OF INTEREST
The authors declare no conflict of interest, financial or otherwise.
ACKNOWLEDGEMENT
Declared none.
REFERENCES
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