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Endoscopy and Thermodiskoplasty: A Minimally Invasive Surgical Treatment for Lumbar Pain

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Samii's Essentials in Neurosurgery

Abstract

Due to the complex physiopathology of lumbar pain and its various multifactorial origins, along with implications on public health, it is clear that the first options we should offer patients suffering from low back pain are conservative alternatives. These options should be applied sequentially, starting with medical options like physical therapy, pain medication, external supports, and facet blocks.

After exhausting noninvasive possibilities, the next step should be minimally invasive surgical options. These techniques, having lower damage to adjacent structures, allow the patient a faster return to day-to-day activity with fewer risks and complications; they also are cost-effective and more esthetic. Likewise, due to their nature, they do not hinder the option of implementing conventional or open techniques in complex cases if they are possible.

Minimally invasive spine surgery (MISS) has fully complied with the philosophy of nowadays surgery. It establishes a new way of thinking, which aims to reduce to the minimum the surgical procedure that would still allow the preservation of function and natural structure of the body and which also prevents iatrogenic processes, without forgetting the main objective of the treatment: relief for low back pain.

It is important to understand the basic, but underlying, aspects regarding its evolution, guidelines, and most relevant techniques. Thus, this chapter will deal with thermodiskoplasty (TDP) and endoscopic techniques for the treatment of lumbar pain like percutaneous endoscopic diskectomy (using transforaminal and extraforaminal approaches), endoscopic foraminoplasty, and endoscopic interlaminar approach and the required tools to perform them.

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References

  1. Bass EC, Nau WH, Diederich CJ, Liebenberg E, Shu R, Pellegrino R, Sutton J, Attawia M, Hu SS, Ferrier WT, Lotz JC (2006) Intradiscal thermal therapy does not stimulate biologic remodeling in an in vivo sheep model. Spine 31(2):139–145

    Article  PubMed  Google Scholar 

  2. Choi G, Lee SH, Bhanot A, Raiturker PP, Chae YS (2007) Percutaneous endoscopic discectomy for extraforaminal lumbar disc herniations: extraforaminal targeted fragmentectomy technique using working channel endoscope. Spine 32(2):E93–E99

    Article  PubMed  Google Scholar 

  3. Feldman A, Hellinger S (2007) Disc FX Non endoscopic Radiofrequency Disc Ablation/Decompression/Nucleotomy. First Experiences. Int J Minim Invasive Spinal Technol 1(1):10

    Google Scholar 

  4. Hellinger S (2008) Disc FX – a new combination procedure for disc surgery. 1th Congress of the ISMISS. Istanbul, 5 Apr 2008

    Google Scholar 

  5. Kim DH, Choi G, Lee SH (2011) Extraforaminal surgical approach. In: Kim DH, Choi G, Lee SH (eds) Endoscopic spine procedures. Thieme, New York, pp 119–121

    Google Scholar 

  6. Knight MT, Goswami A, Patko JT (1999) Endoscopic laser foraminoplasty and an aware-state surgery: a treatment concept and 2-year outcome analysis. Arthroskopie 12(2):62–73

    Article  Google Scholar 

  7. Ramírez JF, Ramírez C, Alonso GO (2011) Experiencia de 15 años de implementación de la cirugía mínimamente invasiva en columna. In: Ramírez J (ed) Dolor lumbar desde la perspectiva del clínico a las imágenes diagnósticas. Fundación Universitaria Unisanitas, Bogotá, pp 119–135

    Google Scholar 

  8. Ramírez JF, Ramírez C, Alonso GO (2011) Tratamiento del dolor lumbar de origen discal y facetaria con cirugía de mínima invasion. In: Ramírez J (ed) Dolor lumbar desde la perspectiva del clínico a las imágenes diagnósticas. Fundación Universitaria Unisanitas, Bogotá, pp 31–54

    Google Scholar 

  9. Ramirez JF, Rugeles JG, Barreto JA, Alonso GO (2010c) Efecto Térmico de la Radiofrecuencia en Discos Intervertebrales. 2th World Congress of Minimally Invasive Spinal Surgery and Technics. Las Vegas, June 2010

    Google Scholar 

  10. Ruetten S (2007) VERTEBRIS lumbal-thorakal. Vollendoskopisches Wirbelsäulen-Instrumentarium. VERTEBRIS lumbal Die vollendoskopische interlaminäre Technik [pdf]. Available at. http://www.richard-wolf.com/no_cache/unternehmen/prospekte/orthopaedie.html

  11. Ruetten S, Komp M, Merk H, Godolias G (2007) Use of newly developed instruments and endoscopes: full endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach. J Neurosurg Spine 6(6):521–530

    Article  PubMed  Google Scholar 

  12. Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique. A prospective, randomized, controlled study. Spine 33(9):931–939

    Article  PubMed  Google Scholar 

  13. Saal JA, Saal JS (2000) Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1-year follow-up. Spine 25(20):2622–2627

    Article  CAS  PubMed  Google Scholar 

  14. Urrútia G, Kovacs F, Nishishinya MB, Olabe J (2007) Percutaneous thermocoagulation intradiscal techniques for discogenic low back pain. Spine 32(10):1146–1154

    Article  PubMed  Google Scholar 

  15. Wetzel FT, McNally TA, Phillips FM (2002) Intradiscal electrothermal therapy used to manage chronic discogenic low back pain new directions and interventions. Spine 27(22):2621–2626

    Article  PubMed  Google Scholar 

  16. Yeung AT, Morrison PC, Felts MS, Carter JL (2000) Intradiscal thermal therapy for discogenic low back pain. In: Savitz M, Chiu J, Yeung A (eds) The practice of minimally invasive spinal technique. AAMISMS Education, Richmond, pp 237–242

    Google Scholar 

  17. Yeung AT, Tsou PM (2002) Posterolateral endoscopic excision for lumbar disc herniation: surgical technique, outcome, and complications in 307 consecutive cases. Spine 27(7):722–731

    Article  PubMed  Google Scholar 

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Correspondence to Enrique Osorio Fonseca MD .

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Fonseca, E.O., Ramírez, J.F., Rugeles, J.G., Cuéllar, G.O.A. (2014). Endoscopy and Thermodiskoplasty: A Minimally Invasive Surgical Treatment for Lumbar Pain. In: Ramina, R., de Aguiar, P., Tatagiba, M. (eds) Samii's Essentials in Neurosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54115-5_10

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  • DOI: https://doi.org/10.1007/978-3-642-54115-5_10

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