[The microscopic assisted percutaneous approach to posterior spine - a new minimally invasive procedure for treatment of spinal processes].

The aim of our attempts and trials was to develop a minimally invasive posterior approach to the spine which utilises the smallest access to the target without additional harmful effects on the stability of the spine and at the same time allows excellent dealing with the lesions depending on the advantage of the operative microscope in providing 3 dimensional view of the operative field. In the period between May 1998 and February 2001, 356 patients were treated for different spinal disorders using this approach. The approach was applied in 299 surgeries for lumbar disc herniation and we called the procedure: microscopic assisted percutaneous nucleotomy (MAPN). The approach was applied in another 34 patients with lumbar canal stenosis to perform what we called microscopic assisted percutaneous decompression (MAPD). The latter was applied for three cases with thoracic canal stenosis and six with cervical canal stenosis. The approach was also applied for other purposes and included myeloscopy in four cases, transpedicular biopsy in six, and transpedicular vertebroplasty in the remaining four. The 43 MAPN done in the early period were re-examined one year after the operation. We achieved 75% good and very good results regarding the relief of the sciatic pain and recovery of the neurological deficits. Re-surgery was necessary in only two cases (4.5%). The results with the use of this technique seem very promising. The minimal trauma induced by this approach allows rapid mobilisation of the patients and short hospital stay. A postoperative back orthoses is not necessary. The technique can also be done under local anaesthesia particularly when needed as in old people with severe co-morbidity.