Inspired by endoscopic knee arthroscopy Schreiber/Leu who were familiar with percutaneous nucleotomy since 1975 thought about how endoscopes could be used for disc visualization and herniated disc treatment. A standard arthroscope was used by Schreiber/Leu 1979.
Material and Methode
Discoscopy has been a more or less first simple step to use endoscopes in treatment of herniated discs. After blunt dilation of the posterolateral access a 4 mm rod lens arthroscope (Karl Storz) was pushed through the working channel of the operation tube of percutaneous nucleotomy instruments-set. The anulus fibrosus and surrounding tissue was inspected first. Afterwards the endoscope was pulled out and mechanical instruments were used to open the anulus and remove gelatinous mass for intradiscal decompression. Next the operaion situs was inspected endoscopically again, before the wound has been closed.
This operation technique did not allow simultaneous use of endoscopes and surgical instruments, therefore this technique was only a bridge to following innovations.
Karl Storz CDD-color video cameras and advanced video towers had been developed and market first in 1987
Endoscopic visualization guided in the right direction and success of arthroscopic treatment for knee surgery inspired surgeons to continue pioneering minimally invasive endoscopic spine surgery.
Leu H.J., Schreiber A.: La nucleotomie percutaneé avec discoscopie: experiences depui 1979 et possibilités aujourd´hui. Rev.Med.Suisse 109 (1989)