Spinal Endoscopy

[cowboy71]

Does anyone have much experience with spinal endoscopy and what is your opinion regarding its future? Will it continue to be regarded as experimental with little usefulness or will someone eventually be innovative enough to further develop it?

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[Aether2000]

I have performed epiduroscopy with several systems including a hysteroscope (flex) but am not impressed with the results. The tools available to be used through the scope are few and the patients cannot differentiate nerve from innervated scar tissue using manual or electrical stimulation.
There are a few guys doing laser discectomy (effectively cutting off the posterior annulus) via an epiduroscope and one guy actually suspends the patient in a harness during the procedure.

Posteriolateral approach and interlaminar spinal endoscopic procedures are slowly making headway across the US and in Europe, esp in Germany and Switzerland...but the learning curve is steep....
Perhaps in the future it may become mainstream....

 

[ampaphb]

Mike:

I know you are the go to guy on this topic, but how do you get to play with these toys without having to lay out the cash and buy them? Do they train you? Or do you have to go to their training on your own dime?

I have also heard tell that while Tony Yeung (sp?) in AZ used to train pain docs, he stopped doing so when is ortho colleagues expressed their displeasure.

 

[Aether2000]

I convinced a surgery center to purchase the epiduroscopy equipment (2 separate types of scopes) and was able to cajole 2 surgery centers to purchase the endoscopy equipment. It can be had for only a small investment if used equipment is available or if the cameras/light fiberoptics/lasers are already being used for another purpose.

Tony sadly did stop training pain docs. I was one of the lucky few...but have found additional training in Paris, Florida, Zurich, and Seoul.