Due to advances in spinal endoscopy, practitioners are now able to offer efficacious alternatives to open surgery to patients with low back pain, radiculopathy, and related disorders affecting the epidural space. Epiduroscopy enables surgeons to access, diagnose, and treat discogenic pain and spinal pathologies using minimally invasive techniques via direct visualization and focused intervention. Typically performed as a one-day outpatient procedure under local anesthesia, epiduroscopy provides a viable option to many patients suffering from low back pain.
Starting with the history of this procedure, the authors guide the reader systematically through relevant clinical indications, radiological anatomy, the pathophysiology of spinal pain, diagnostic modalities, and the use of specialized tools. Subsequent chapters detail specific conditions and approaches, histopathologic/microbiological findings, and patient assessment and outcomes.
Key Features
- Clinical pearls gleaned from years of hands-on experience, including preventing and managing complications.
- Online access to 46 step-by-step surgical videos and animations provides in-depth understanding of techniques.
- Nearly 600 high quality images, including procedural photos and medical illustrations delineate approaches.
- The use of epiduroscopy-assisted mechanical adhesiolysis, laser procedures, radiofrequency, analgesic and pharmacological therapy, ozone therapy, spinal cord stimulation, and more.
This is an essential resource for trainee and practicing physicians in the fields of neurosurgery, orthopaedic surgery, pain medicine, and interventional medicine.
Índice de Epiduroscopy Atlas of Procedures
Menu of Accompanying Videos
Preface
Acknowledgments
Contributors
1 The History of Epiduroscopy
2 Applied and Radiological Anatomy of the Epidural Space for Spinal Endoscopy
3 Pathophysiology of Spinal Pain and Pain Pathways
4 Anatomic Origin of Spinal Pain and Clinical
5 Diagnostic Studies and Radiographic Imaging Modalities for Spine-Related
6 Epiduroscopy Equipment
7 Epiduroscopic Surgical Tools
8 Clinical Indications and Considerations for Epiduroscopy
9 Sacral Hiatus Epiduroscopic Approach
10 Transforaminal and Interlaminar Approaches in Epiduroscopy
11 Epiduroscopic Images of Spinal Anatomy
12 Evaluation of Epidural Pathology and Epiduroscopic Images
13 Diagnostic and Functional Epiduroscopic Procedures
14 Epiduroscopic, Histopathologic, and Microbiological Findings
15 Anesthetic Management for Epiduroscopy
16 Step-by-Step Epiduroscopic Techniques
17 Spinal Epiduroscopic Mechanical Adhesiolysis
18 Spinal Epiduroscopic Laser Therapy
19 Epiduroscopic Procedure Using the 1,414-nm Nd:YAG Laser (Lutronic Laser)
20 Spinal Epiduroscopic Radiofrequency Therapy
21 Transforaminal Epiduroscopic Laser Annuloplasty for Diskogenic Pain
22 Spinal/Epidural Analgesic and Pharmacologic Therapy
23 Epiduroscopy-Assisted Spinal Cord Stimulator Electrode Implantation
24 Epiduroscopic Ozone Therapy
25 Patient Assessment for Epiduroscopy
26 Epiduroscopy: Complications and Complication Avoidance
27 Clinical Outcomes of Epiduroscopy
Appendix: Intraoperative Endoscopic Images of Pathologic Anatomy of the Neuraxial Region
Index
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