Neurosurgery

Advances in Minimally Invasive Surgery and Therapy for Spine by Alberto Alexandre, Marcos Masini, Pier Paolo Maria Menchetti

By Alberto Alexandre, Marcos Masini, Pier Paolo Maria Menchetti

Radiologists, orthopedic and neurological surgeons current the several minimally invasive equipment. Peripheral nerve difficulties and difficulties touching on differential analysis in unique occasions similar to among radicular and peripheral nerve trunk lesions are mentioned, pinpointing the importance of other diagnostic instruments. Minimally invasive ideas, applied these days to reduce bone demolition, scarring and chance of recurrence are analyzed. Microdiscectomy is in comparison with the result of intradiscal ideas, and new equipment are mentioned dealing with difficulties reminiscent of epidural fibrotisation, microinstability, osteoporotic or neoplastic or posttraumatic vertebral lesions.

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1985) Percutaneous lumbar discectomy using a new aspiration probe. AJR Am J Roentgenol. 144:1137 40 16. Yasargil MG. (1977) Microsurgical operations for herniated lumbar disc. Adv Neurosurg. 4:81 2 17. McCulloch JA. (1989) Principles of microsurgery for lumbar disc disease. Raven Press, New York 18. Choy DS, Ascher PN, Soddekini S. et al. (1992) Percutaneous laser disc decompression. Spine. 17:949 56 19. Alexandre A, Buric J, Paradiso R. et al. (2001) Intradiscal injection of oxygen ozone for the treatment of lumbar disc herniations: result at 5 years.

III. The Evaluation of Therapeutic Response. Annals of Internal Medicine 61: 944 965. 8. Feinstein A (1964) Scientific Methodology in Clinical Medicine. IV. Acquisition of Clinical Data. Annals of Internal Medicine 61: 1162 1193. 9. Gray G (2002) Evidence Based Medicine: An Introduction for Psychiatrists. Journal of Psychiatric Practice 8: 5 13. 10. Hanson B (2007) The Quest for the New. In Szpalski M, Gunzburg R, Le Huec J, Brayda Bruno M (Eds) Nonfusion Technologies in Spine Surgery. Philadelphia: Lippincott Williams & Wilkins.

They include, among others, the ‘‘Reliefer,’’ which is a very similar device to the Onik one, ‘‘Laserdiscectomy’’ (first performed by Choy [18] in 1986) carried out by inserting the laser probe in the centre of the disc, and the ‘‘Nucleoplasty’’ which uses radiofrequency to generate a temperature of 50 60 that produces a thermic coagulation of the disc tissue, as well as biochemical changes in the latter. Other methods are represented by intradiscal injection of a mixture of ‘‘oxygen-ozone’’ [19], or laserdiscectomy performed under CT scan [20].

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