Endoscopic Lumbar Decompression

 

What is Endoscopic Lumbar Decompression?

The concept of Endoscopic Laser Decompression & Foraminoplasty is the reduction of lumbar segmental pain by removal of causal pain sources whilst preserving motion at the segment by:

    • Mobilisation of the nerve from the annulus (Disc wall)
    • Enlargement of the foramen (Undercutting decompression)
    • Removal of disc compression (Discectomy)
    • Removal of osteophytes impacting upon the nerve (Osteophytectomy)
    • Removal of ligaments tethering or impinging upon the nerve (Neurolysis)
    • Shrinkage of redundant annulus (Annuloplasty)
    • Removal of perineural scarring or granulation tissue

The concept underlying Posterior Lumbar Interbody Fusion is reduction of lumbar segmental pain by addressing pain arising from the disc and nerve by:

    • Stopping pathological motion
    • Removing compression from the nerve
    • Restoring disc height
    • Opening the foraminal height
    • Preventing progressive deformity
       

The concept underlying Posterior Decompression is reduction of lumbar segmental pain by addressing pain arising from the disc and nerve by:
 

    • Enlargement of the foramen (Undercutting decompression)
    • Removal of disc compression (Discectomy)
    • Removal of osteophytes impacting upon the nerve (Osteophytectomy)
       

The Derivation of Endoscopic Lumbar Decompression

The Endoscopic Lumbar Decompression was derived from experience with Endoscopic Laser Foraminoplasty. This in turn was developed from Percutaneous Discectomy, Laser Disc Decompression and Flexible Endoscopic Intradiscal Discectomy
 

Endoscopic Laser Foraminoplasty has been substantially modified by the provision of manual and powered instrumentation, advanced endoscopic equipment and radiofrequency ablation devices to provide a more effective means of decompression of the nerve and Lateral Recess Stenosis.
 

The technique has advanced along the conventional concept of undercutting and enlarging the foramen to treat the Lateral Recess Stenosis. It differs from the conventional technique which uses a posterior approach working laterally by approaching posterolaterally and working medially.
 

The differences between Endoscopic Lumbar Decompression and Endoscopic Laser Foraminoplasty are shown in the following table.