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DOI: 10.1055/s-2003-37962
Endoscopic Surgery of the Lumbar Epidural Space (Epiduroscopy): Results of Therapeutic Intervention in 93 Patients
Publikationsverlauf
Publikationsdatum:
17. März 2003 (online)
Abstract
Determination and therapy of the underlying pathology in chronic pain syndrome in the lumbar spine is frequently difficult. Minimally invasive and microsurgical techniques may offer advantages. Epiduroscopy is available for visualization of the lumbar epidural space. 93 patients with chronic back-leg pain syndrome were epiduroscopically operated. When findings were appropriate, mechanical instruments and the holmium:YAG laser were applied therapeutically. 45.9 % of these patients presented with positive results in postoperative examination. Pathomorphological processes corresponding to the multifactorial pain processes, which escape detection in modern imaging procedures, can be diagnosed in the epidural space using epiduroscopy Therapeutic intervention is basically possible. However, use is limited due to technical difficulties. Navigation of the endoscope is especially limited in access via the hiatus sacralis.
Key words
Epiduroscopy - Minimally Invasive Spine Surgery - Chronic Lumbar Pain - Epidural Adhesions
References
- 1 Blomberg R, Olson S S. The lumbar epidural space in patients examined with epiduroscopy. Anesth Analg. 1989; 68 157-160
- 2 Burmann M S. Myeloscopy or the direct visualization on the spinal cord. J Bone Joint Surgery. 1931; 13 695-696
- 3 Epstein J, Adler R. Laser-assisted percutaneous endoscopic neurolysis. Pain Physician. 2000; 3 43-45
- 4 Fairbank J CT, Couper J, Davies J B, O Brien J P. The Oswestry low back pain questionnaire. Physiotherapy. 1980; 66 271-273
- 5 Heavner J F, Cholkhavatia S, Kizelshteyn G. Percutaneous evaluation of the epidural and subarachnoid space with the flexible fibrescope. Reg Anesth. 1991; 15S1 85
- 6 Möllmann M, Host D, Enk D. Spinaloskopie zur Darstellung von Problemen bei der Anwendung der kontinuierlichen Spinalanästhesie. Anästhesist. 1992; 41 544-547
- 7 Pose B, Sangha O, Peters A, Wildner M. Validierung des North American Spine Society Instrumentes zur Erfassung des Gesundheitsstatus bei Patienten mit chronischen Rückenbeschwerden. Z Orthop. 1999; 137 437-441
- 8 Saberski L R, Kitahata L M. Persistent radiculopathy diagnosed and treated with epidural endoscopy. J Anesth. 1996; 10 1-4
- 9 Schütze G, Kurtze H. Percutaneous investigation of the epidural space using a flexible endoscope: A contribution to epiduroscopy. Reg Anesth. 1993; 18 (1S) 24
- 10 Trost D, Zacherl A, Smith M. Surgical Laser Properties and Their Tissue Interaction. Mosby-Year Book, Inc 1992 12
Dr. med. S. Ruetten
Ressort Spine Surgery and Pain Therapy · Orthopaedic Clinicat the Faculty of Radiology and Microtherapy · University of Witten/Herdecke · St. Anna-Hospital
Hospitalstraße 19
44649 Herne
Germany
Telefon: +49-2325-986-2022
Fax: +49-2325-986-2049
eMail: s-ruetten@t-online.de