Endoscopic Surgery of the Thoracic and Lumbar Spine - A Report on 500 Treatments

Abstract

During the last 6 years, endoscopic procedures have developed from being optional, additional intervention procedures to being the standard procedures for treating spinal trauma. They are based on the principles of traditional spinal surgery, i. e., reduction, reconstruction and retention of the anterior section of the spine. This development has been accompanied by a continual improvement of instruments, which also enables subtile interventions, such as anterior decompression of the myelon, under visual conditions that can only be compared to those of the surgical microscope, to be performed. The high level of primary and angular stability of modern implants makes exclusive anterior treatment seem possible in the case of suitable injury patterns, where dorsal intervention, which creates soft tissue trauma, does not have to be considered. Limiting factors include the extent of the malalignment that is to be corrected, damage to posterior structures and unsatisfactory bone quality, which always require additional posterior reconstruction and stabilisation measures. The safety of endoscopic surgery is reflected in the low rate of complications and short surgery times, which are comparable to those of open procedures. Endoscopic methods were introduced with the intention of reducing access morbidity, and this objective has been successfully realised. The reported complications are an expression of the dangers and limits of the procedures, of diagnosis and the risky subject of spinal surgery, which cannot be changed, even through the use of endoscopy.

Key words

Endoscopic surgery - thoracic spine - lumbar spine

References

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