Abstract
Determination and therapy of the underlying pathology in chronic pain syndrome in
the lumbar spine is frequently difficult. Minimally invasive and microsurgical techniques
may offer advantages. Epiduroscopy is available for visualization of the lumbar epidural
space. 93 patients with chronic back-leg pain syndrome were epiduroscopically operated.
When findings were appropriate, mechanical instruments and the holmium:YAG laser were
applied therapeutically. 45.9 % of these patients presented with positive results
in postoperative examination. Pathomorphological processes corresponding to the multifactorial
pain processes, which escape detection in modern imaging procedures, can be diagnosed
in the epidural space using epiduroscopy Therapeutic intervention is basically possible.
However, use is limited due to technical difficulties. Navigation of the endoscope
is especially limited in access via the hiatus sacralis.
Key words
Epiduroscopy - Minimally Invasive Spine Surgery - Chronic Lumbar Pain - Epidural Adhesions
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Dr. med. S. Ruetten
Ressort Spine Surgery and Pain Therapy · Orthopaedic Clinicat the Faculty of Radiology
and Microtherapy · University of Witten/Herdecke · St. Anna-Hospital
Hospitalstraße 19
44649 Herne
Germany
Telefon: +49-2325-986-2022
Fax: +49-2325-986-2049
eMail: s-ruetten@t-online.de