The clinical results of the full-endoscopic technique are equal to those of the microsurgical technique. At the same time, there are advantages in the operation technique and reduced traumatization. With the surgical devices and the possibility of selecting an interlaminar or posterolateral to lateral transforaminal procedure, lumbar disc herniations outside and inside the spinal canal can be sufficiently removed using the full-endoscopic technique, when taking the appropriate criteria into account. Full-endoscopic surgery is a sufficient and safe supplementation and alternative to microsurgical procedures.

The recorded results show that the full-endoscopic posterior foraminotomy is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Even with good results, conventional disc operations may result in consecutive damage due to traumatisation. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. The transforaminal operation is the most common full-endoscopic procedure in surgery of the lumbar spine. It is frequently necessary to reach the spinal canal directly in order to achieve sufficient resection of lumbar disc herniations. Even in using a lateral approach, the authors recognise the clear limitations of the transforaminal procedure. The objective of this prospective study was to examine the technical possibility of a full-endoscopic interlaminar access. The focus was on questions of sufficient decompression, as well as advantages and disadvantages of the minimally invasive procedure. 331 patients were followed for 2 years. The results show that 82 % reported no longer having leg pain, and 13 % had only occasional pain. The decompression results are equivalent to those of conventional procedures. Traumatisation of both the access pathway and the spinal canal structures was reduced. Epidural scarring was minimised. The recurrence rate was 2.4 %. No serious surgical complications were observed. The authors view the technique described, which offers the advantage of a truly minimally invasive procedure, as a sufficient and safe alternative to conventional procedures, when the appropriate indication criteria are heeded. There are technical problems because of the small instruments. In conjunction with the transforaminal procedure, this is an expansion of the spectrum for full-endoscopic surgery of lumbar disc herniations.

The technique presented is an adequate and safe alternative to conventional procedures, and has the advantages of a truly minimally invasive procedure. The extreme lateral access is required for the indications described. There are clear limitations outside these indications. The possibility of selecting an access from posterolateral to extreme lateral now enables surgery of lumbar disc herniations inside and outside the spinal canal.

Object Even with good results, conventional disc operations may result in subsequent damage due to trauma. Endoscopic techniques have become the standard in many areas because of the advantages they offer intraoperatively and postoperatively in rehabilitation. The goal of this prospective study was to examine the expanded technical possibilities of full-endoscopic transforaminal and interlaminar resection of herniated lumbar discs in which the authors used newly developed optics and instruments. The focus was on questions of achieving sufficient decompression, as well as the advantages and disadvantages of the minimally invasive procedure. Methods Two hundred thirty-two patients underwent follow up for 2 years after undergoing surgery. In addition to general and specific parameters, the following measuring instruments were used: a visual analog scale, the German version of the North American Spine Society instrument, and the Oswestry Disability Index of low-back pain disability. Postoperatively 84% of the patients no longer had leg pain, and 12% had only occasional pain. The results of decompression were equivalent to those of conventional procedures. The incidence of traumatization was reduced. Epidural scarring was minimized. The recurrence rate was 6.0%. No serious surgical complications were observed. Resection of the herniated disc was technically possible in all cases in which the new instruments were used. Conclusions The authors view the aforedescribed techniques, which offer the advantages of a truly minimally invasive procedure, as a sufficient and safe supplementation and alternative to conventional procedures, when the appropriate indication criteria are heeded. The new endoscope with its 4.2-mm working channel and corresponding instruments significantly reduced the technical problems.

Object Extensive decompression with laminectomy where appropriate is often still described as the method of choice in surgery for lateral recess stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the advantages they offer in surgical technique and in rehabilitation. Transforaminal and interlaminar access provide 2 full-endoscopic (FE) techniques for lumbar spine surgery. The goal of this prospective randomized controlled study was to compare the surgical results for the FE technique via the interlaminar approach with those of the conventional microsurgical technique in patients with degenerative lateral recess stenosis. Methods A total of 161 patients with FE or microsurgical decompression underwent follow-up for 2 years. In addition to general and specific parameters, the following measuring instruments were used: visual analog scale, German version of the North American Spine Society instrument, and the Oswestry low-back pain disability questionnaire. Results The results show that 74.5% of patients reported no longer having leg pain, and 20.5% had only occasional pain. The clinical results were the same in both groups. The rate of complications and revisions was significantly reduced in the FE group. The FE techniques brought advantages in the following areas: operation, complications, traumatization, and rehabilitation. Conclusions The clinical results of the FE interlaminar technique are equal to those of the microsurgical technique. At the same time, there are advantages in the operation technique, such as reduced traumatization. The FE interlaminar spinal decompression procedure is a sufficient and safe supplement and alternative to microsurgical procedures.

Anterior cervical decompression and fusion (ACDF) is the standard procedure for operation of cervical disc herniations with radicular arm pain. Mobility-preserving posterior foraminotomy is the most common alternative in the case of a lateral localization of the pathology. Despite good clinical results, problems may arise due to traumatization of the access. Endoscopic techniques are considered standard in many areas, since they may offer advantages in surgical technique and rehabilitation. These days, all disc herniations of the lumbar spine can be operated in a full-endoscopic technique. The objective of this prospective study was to examine the technical possibilities of full-endoscopic posterior foraminotomy in the treatment of cervical lateral disc herniations. 87 patients were followed for 2 years. The results show that 87.4% no longer have arm pain and 9.2% have only occasional pain. The decompression results were equal to those of conventional procedures. The operation-related traumatization was reduced. The recurrence rate was 3.4%. No serious surgical complications occurred. The recorded results show that the full-endoscopic posterior foraminotomy is a sufficient and safe supplement and alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.

Anterior cervical decompression and fusion (ACDF) is the standard for cervical discectomies. With the full-endoscopic anterior cervical discectomy (FACD) a minimally invasive procedure is available. The objective of this prospective, randomised, controlled study was to compare the results of FACD with those of ACDF in mediolateral soft disc herniations. A total of 103 patients with ACDF or FACD were followed up for two years. In addition to general parameters specific measuring instruments were used. Postoperatively 85.9% of the patients no longer had arm pain, and 10.1% had occasional pain. There were no significant clinical differences between the decompression with or without fusion. The full-endoscopic technique afforded advantages in operation technique, rehabilitation and soft tissue injury. The recorded results show that FACD is a sufficient and safe alternative to conventional procedures when the indication criteria are fulfilled. At the same time, it offers the advantages of a minimally invasive intervention.