Minimally Invasive Lumbar Spinal Surgery.
The Objectives
The goals of minimalist spinal surgery are the need to improve diagnosis and the efficacy of treatment whilst reducing morbidity, mortality, and ultimately the overall cost of the procedure. The objective should be the sufficient removal of disc material, minimal retraction of nerve roots, meticulous haemostasis, the specific and targeted treatment of causal pathology, the preservation of spinal stability, minimisation of muscle dissection, decreased post-operative pain, lessening hospitalisation and acceleration of restored functionality and Return to Work.

What is SED/YESS?
Selective Endoscopic Discectomy™ (SED™) is a minimally invasive spine surgery technique that utilizes an endoscope to treat herniated, protruded, extruded, or degenerative discs that are a contributing factor to leg and back pain. The endoscope allows the surgeon to use a “keyhole” incision to access the herniated disc. Muscle and tissue are dilated rather than being cut when accessing the disc. This leads to less tissue destruction, less postoperative pain, quicker recovery times, earlier rehabilitation, and avoidance of general anesthesia. The excellent visualization via the endoscope permits the surgeon to selectively remove a portion of the herniated nucleus pulposus that is contributing to the patients’ leg and back pain.

RELIEF FOR ACHING BACKS
If you have ever said, “Oh my aching back,” you have plenty of company. Eight out of 10 Americans will suffer back pain at some point in life, according to the National Institutes of Health (NIH).

One frequent cause of debilitating back pain is a herniated disk, the soft rubbery pad found between each of the vertebra that allows flexing or bending. A ruptured disc occurs when part of the center nucleus pushes the edge of the disc into the spinal canal, putting pressure on the nerves and causing pain in both the back and legs.

Przezskórna laserowa dekompresja dysku lędźwiowego
This article describes the development of minimally invasive methods in the treatment of lumbar discopathy, with particular attention to percutaneous laser disc decompression (PLDD). The authors discus the therapeutic operating mechanism of PLDD, emphasizing the importance of the thermal characteristics of laser light, which is responsible for the vaporization and ablation of a small amount of tissue from the nucleus pulposus. This causes a significant reduction in pressure in the closed structure of the disc, and consequently reduced compression exerted by the disk on the dural sac and the nerve roots. Improvement in the flow of cerebro-spinal fluid has also been observed on the level at which the operation is performed. On the basis of our own experience and the reports of other authors, we have specified indications and contra-indications for PLDD. Our conclusion is that PLDD is an effective treatment method for low back pain and ischialgia caused by protrusion or herniation of the nucleus pulposus, with elimination or significant reduction in symptoms in over 75% of those treated; reduction or resolution of neurological deficits that arise in the course of lumbar discopathy has also been observed. This method enables one-stage treatment of multi-level degenerative changes in the intervertebral disc. The only absolute contraindications for PLDD are the presence of sequestration, disturbances in blood coagulation, and bacterial infection.

Spine Universe Author Biography
Doctor Yeung is a board certified orthopaedic and spine surgeon who has extensive experience in minimally invasive spinal diagnostic and surgical techniques. He subspecializes in percutaneous endoscopic surgery of the lumbar spine and has developed the Yeung Endoscopic Spine System (YESS™), which includes multi-channel spine endoscopes and related instruments by the Richard Wolf Surgical Instrument Company.
Dr. Yeung is recognized internationally and nationally for his contributions to minimally invasive/endoscopic spine surgery. He is the co-editor of the book The Practice of Minimally Invasive Spinal Technique and the author of numerous peer-reviewed articles, publications, and book chapters on endoscopic spine surgery and related topics. He is a reviewer for Spine, Pain Physician, and is a member of the editorial review boards of Pain Physician and the Journal of Minimally Invasive Spinal Technique.

Algos Literature References