Surgical treatment of lumbar disc herniation was �first described in 1934 by Mixter and Barr.
Refinement in the procedure came from Love, who first reported an extradural approach
of the disc. A major step in this type of surgery was the introduction of operative microscope
by Caspar and Yasargil in 1977. This approach allowed better visualization, less invasiveness
and reduction of perioperative morbidity, thus becoming the gold standard technique for open
discectomy. Since then and along the years, perpetual seek of less traumatic lumbar disc surgery
in order to improve clinical outcomes show advents in the development of various minimally
invasive techniques.With associated neuroendoscopy growing rapidly in the last 20 years as a minimally therapeutic modality for treatment of a variety of spinal disorders.Meanwhile, the advances in optics and instrument design have led to the successful application of less invasive surgical principles to the abdomen, the thoracic cavity and several joints, where the surgical efficacy is at least similar to that of the conventional,more invasive approaches, but with decreased hospital stays and shorter recovery times. With these criteria in mind, some surgeons have tried to combine the less invasive microsurgical technique
by the traditional midline posterior approach with modern endoscopic technology. They have
developed new systems for endoscopic posterior discectomy, either by a conic freehand working channel. A special device for endoscopic surgery of lumbar disc herniation. or by a tubular retractor, introduced by Foley
and Smith.This latest innovation of the endoscopic discectomy is a hybrid between posterior endoscopic lumbar discectomy and the open microsurgical discetomy called microendoscopic discectomy. |
