Epiduroscopy (Epidural Endoscopy)

Abstract

Epiduroscopy is a relatively new technique used in the evaluation and treatment of low back pain via advancements in optical fiber technology. As a minimally invasive endoscopic technique, it allows for direct endoscopic imaging of the epidural space and helps the patients for the pain management who having post-lumbar surgery syndrome (PLSS) and other cases of low back pain and radiculopathy. An advanced understanding of the anatomy of epidural space and adjacent structures are also essential for positive and successful clinical outcomes. The use of epiduroscopy in the pain clinic is performed as a day procedure, and the patient is awake and can communicate with the doctor. During an epiduroscopy, thin tubes with a bright light and tiny fiberoptic camera at the end are inserted through the sacral hiatus into the epidural space around the dura and guided up toward the affected site. Anterior epiduroscopy and epiduroscopic laser neural decompression (ELND) have been recently introduced in treating herniated disc decompressions, and chronic low back pain and radicular pain, respectively. The most common complications of epiduroscopic approach are the pain in the intervention point, dural puncture, and headache.

Evaluation of Increased Intracranial Pressure with the Optic Nerve Sheath Diameter by Ultrasound in Epiduroscopic Neural Laser Discectomy Procedures

“…When the first studies on epiduroscopy were carried out, only the posterior epidural area was reached by the epiduroscopy method, while anatomical structures were displayed and pathological structures were distinguished. More recently, fibrotic structures and adhesions occurring in the posterior epidural area have been treated in patients with failed back surgery syndrome (1,18,19).…”

A Novel Combination Technique: Three Points of Epiduroscopic Laser Neural Decompression and Percutaneous Laser Disc Decompression With the Ho:YAG Laser in an MSU Classification 3AB Herniated Disc

“…Epiduroscopy is a minimally invasive technique that has been frequently used in recent years for spinal diseases . Fundamentally, epiduroscopic procedures enable direct imaging of spinal structures in the treatment of lumbar spinal stenosis and chronic lumbar and/or leg pain; dilution of biomechanical irrigators such as phospholipase A2 and tumor necrosis factor with saline; and targeted injections .…”

Regional and age features of the structure of connective tissues structures of the epidurals pace of the human spinal cord

“…Некоторые исследователи [10][11][12][13][14] считают, что соединительнотканные структуры эпидурального пространства являются признаком дегенеративно-дистрофических заболеваний позвоночника и последствием оперативных вмешательств, могут служить причиной боли в спине и конечностях. Систематический обзор и мета-анализ S. Helm с соавт.…”