Target orianted herniated endoscopic disc treatment(H. Matthew; T. Hoogland / Danek Inc. - H.J.Leu; Schreiber / Karl Storz Endoscopy)
1991 two medical teams guided in cooperation with medical manufacturers, almost simultaneously, endoscopic intervertebral disc treatment with Foraminoscopy to a new dimension.
The minimally invasive surgical techniques to the spine based until 1991 on the tissue-saving posterolateral approach on the principle of intradiscal decompression and was suitable only for protrusions.This type of action assumes that by removing of gelatinous mass and the associated reduction in volume, the protrusion of the anulus fibrosis will colaps and thereby relieves the compressed nerve from pressure.
The competing method, microdiscectomy, creating a target oriented, dorsal, interlaminar access to the pathogenic tissue, which treats out of anulus fibrosus, and is removed directly and thus decompresses the affected nerv.
The Foraminoscopy has the same potential as the microdiscectomy. By the tissue saving posterolateral approach the prolapsed disc tissue is removed under endoscopic view, target oriented directly at it´s origin.
On the rare foraminal and extraforaminal lumbar disc herniation it requires no removal of boney substance of the vertebral joint. This surgical technique pursued Leu / Schreiber 1991, with an Endoscope, specified by them and manufactured by Karl Storz. The technical requirements were adequately met by design, optical quality and appropriate instruments. For the mentioned purpose they are still in use.
H. Matthews / T. Hoogland had the goal to treat also the more frequent paramedian and median disc herniations via postero lateral Foraminoscopy and Dr. Hoogland ordered Danek´s first Foraminoscopic Endoscopy System in 1992.
Using the 0 ° fiber optics and the operation cannula with 6.5 mm diameter target area for paramedian and median disc herniation could not be reached, also the optic quality and viewing direction was poor. The mechanical design with 180 mm working length, 3.6 mm working channel for 3.5 mm instruments, an endoscope outer diameter of 6 mm and an operation cannula of 6.5 mm outer diameter should becomea model for design for many endoscope manufacturers seven years later.
The production of Foraminoscopes has been abandoned by Danek Inc. in 1994