, Volume 151, Issue 9, pp 1035-1036

Endoscopic lumbar disc surgery: The hammer and the nail problem or the “Not-So-Easy Go” system

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The saying goes: “if you have a hammer, everything looks like a nail”.

This holds true for the communication by Oertel et al. [1], despite the honesty they display in it for which they are to be commended.

I am grateful for the opportunity to write an editoral, because it may help to clarify some issues:

Although there is no proof at all that minimally invasive access translates into a clinically meaningful advantage[2], the perpetual quest for it is understandable and certainly justified. It is my firm conviction that papers dealing with this topic are necessary, because progress in science as well as advances in surgery will always come in very small steps these days.

Thus, refuting new techniques or modifications completely for the above reason is not my concept at all. However, two prerequisites need to be met when a new technique is promoted:

  1. It should truly represent a visible advantage over existing techniques with respect to minimal invasiveness.

  2. At least equivalence to standard