Evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis.

The objective of this chapter was to demonstrate evolving transforaminal endoscopic microdecompression for herniated lumbar discs and spinal stenosis, and to become accomplished with endoscopic micro spinal instruments and laser application. Since 1993, 2000 patients with 3421 herniated lumbar discs were diagnosed with symptomatic lumbar single and multiple herniated intervertebral discs. Progressive series of different diameters endoscopic-assisted tubular retractors, with appropriate-sized dilators and more aggressive saw-toothed trephines, and laser were used to perform transforaminal endoscopic micro-decompression, in addition to the posterior-lateral foraminoscope and endoscopic-assisted spinal operating systems. No postoperative mortalities occurred, and the morbidity rate was less than 1%, in the 2000 patients. For a single level, 94% of the patients had good or excellent results; 6% had some residual symptoms although improved overall. Transforaminal endoscopic laser microdecompression can effectively decompress herniated lumbar discs and spinal stenosis, when foraminoplasty is performed, which provides a safe and effective modality to achieve results in effective spinal decompression, preserves spinal motion, and creates a channel for spinal arthroplasty.