2009-09-25 11:38:26 - Arthroscopic Laser Treatment of Spinal Disorders For decades, spine surgeons have used large incisions to treat spinal conditions. Large and invasive incisions necessitate patients be .......

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Arthroscopic Laser Treatment of Spinal Disorders

For decades, spine surgeons have used large incisions to treat spinal conditions. Large and invasive incisions necessitate patients be hospitalized and includes extensive rehabilitation and a lengthy and painful recuperation. Since the early 1970s, the arthroscope has been utilized to operate on knees and shoulders


Patient Benefits

This type of minimally invasive surgery is performed on an outpatient basis using a local anesthetic. Since general anesthesia is not used, surgical risks are less. Arthroscopic surgery and use of endoscopic tubes minimizes muscle and other soft tissue damage


Arthroscopic Spine Procedures

Depending on the patient’s diagnosis and

surgical needs, sometimes more than one procedure is performed during a single surgery.

There are 4 primary arthroscopic spine procedures : -

1. Foraminotomy : - A foraminotomy helps to relieve symptoms caused by nerve root compression. The foramen are passageways between the vertebrae through which nerve roots exit the spinal canal. A foraminotomy may be performed to treat foraminal stenosis, bulging or herniated discs, pinched nerves, scar tissue formation, bone spurs (osteophytes), spinal arthritis, or sciatica.



Laser Spine Surgery : -

The most commonly performed spinal operation in the United States is the lumbar discectomy. Lumbar discectomy is the cornerstone of surgical treatment of disc herniations.


Percutaneous Automated Discectomy [PAD]/ Percutaneous Laser Discectomy [PLD]

The potential to obtain access to the disc by placing a needle with x-ray guidance remained attractive. Alternative methods to remove disc material with better control than chymopapain were developed. Mechanical cutting and suction devices passed over the needle placed into the disc "ate" the inner core of the disc


Modern Convergence: Percutaneous Arthroscopic (Endoscopic) Discectomy

Technological advancements have continued, especially with fiberoptics allowing direct light source and visualization through a small channel. With slight modifications of the percutaneous techniques, a slightly larger cannula or channel can be directed over a needle into the disc space. Through this cannula or channel the disc can be directly visualized on a screen



Parallel Evolution: Spinal Fusion

Traditional spinal fusion techniques are varied and require fairly destructive approaches to normal tissue, and generally are augmented with spinal instrumentation. Therefore, there is an even greater push to define easier, less destructive and more direct methods to perform spine fusions. Using the percutaneous ideas


Video-Assisted Spinal Arthrodesis (Vasa)

Following the lead of other surgical specialities, spine surgeons have turned to video-assisted spine arthrodesis (VASA) or spine fusion. Video-assisted spine surgery allows the placement of structural grafts, similar to those used now for spine fusions






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