This book provides easy-to-use guidelines and how-to-do instructions on the benefits and risks of laser application, decision-making and patient selection and especially on the clinical application of lasers. It thoroughly covers the areas of arthroscopic surgery, spine surgery and open surgery.
This practical guide, beautifully illustrated with line drawings and images throughout, covers the basic science, laser physics, patient selection, diagnostic maneuvers and useful imaging methods of PLDD. In addition, step-by-step instructions are given on needle placement, how to enter difficult discs, and delivery of laser energy. Also included are chapters on possible complications and how to manage them, when to consider a repeat procedure, as well as long term rehabilitation.
Percutaneous lumbar discectomy is a new surgical method for treating lumbar disc diseases. The goal of the procedure is decompression of the spinal nerve root by percutaneous removal of the nucleus pulposus under local anesthesia. Probably 20 % of all patients requiring lumbar disc surgery can be successfully treated by this method. During the past two years, percutaneous discectomy has spread rapidly, and it is now performed in most clinical departments engaged in spinal surgery. The first International Symposium on Percutaneous Lumbar Discectomy, held in Berlin in August 1988, covered all current procedures known as "percutaneous discectomy" and the entire range of percutaneous techniques, both clinical and experimental. Its publication is important because of the recency of this new surgical procedure, the outstanding experience of the speakers - including the Japanese, American, and European "pioneers" of the technique - and last but not least the gaps in the knowledge of physicians concerning this topic. This procedure opens up new perspectives in the surgical treatment of degenerative diseases of the lumbar spine.
This book describes and illustrates state-of-the-art techniques in laser spine surgery. Laser technology has revolutionized surgeries in many specialties to perform minimally invasive and cutting-edge procedures. Recent advances in spinal surgery have led to the increasingly widespread use of minimally invasive techniques based on endoscopy and microscopy. Nevertheless, the application of laser in the context of spinal surgery remains less well known, and the aim of this book is to present practical usage of laser in spine surgery to our readers. A wide variety of minimally invasive approaches to spine surgery using CO2, Ho: YAG, and Nd: YAG lasers are presented in detail, with a discussion of equipment and specific recommendations on laser settings. Care has been taken to ensure that the content is faithful to the fundamental principles of spine surgery and evidence-based medicine. The book will be an essential resource for all who use or are intending to use lasers in spine surgery.
This comprehensive review covers the full and latest array of interventional techniques for managing chronic pain. Chapters are grouped by specific treatment modalities that include spinal interventional techniques, nonspinal and peripheral nerve blocks, sympathetic interventional techniques, soft tissue and joint injections, and implantables. Practical step-by-step and evidence-based guidance is given to each approach in order to improve the clinician's understanding. Innovative and timely, Essentials of Interventional Techniques in Managing Chronic Pain is a critical resource for anesthesiologists, neurologists, and rehabilitation and pain physicians.
Endoscopy of the spinal canal – epiduroscopy (EDS) – has proven to be a safe, efficient and future-oriented interventional endoscopic procedure for everyday clinical use in diagnosing and managing pain syndromes. Epiduroscopy can be used in the sacral, lumbar, thoracic and even cervical regions of the spine to identify pathological structures, carry out tissue biopsies and perform epidural pain provocation tests to assess the pain relevance of visualized anomalies, making it an excellent diagnostic tool. Spinal endoscopy allows targeted epidural analgesic pharmacologic therapy for affected nerve roots or other painful regions in the epidural space. Treatment options provided by epiduroscopy include laser-assisted adhesiolysis or resection of pain-generating fibrosis, catheter placement, as well as support with other invasive procedures for pain relief. Professional EDS management enhances a multimodal philosophy and opens up new treatment strategies for patients. If used early on, it can control pain well before chronicity sets in.
Advances in Intervertebral Disc Disease in Dogs and Cats defines our present knowledge of this common clinical problem, compiling information related to the canine and feline intervertebral disc into a single resource. As a comprehensive, focused work, the book is an authoritative reference for understanding and treating disc disease, providing a sound scientific and clinical basis for decision making. Offering an objective synthesis of the current literature, the book supplies guidance on the approach to a potential disc rupture, surgical and medical strategies, and management of the patient. Offering a complete understanding of intervertebral disc disease, the book describes and discusses the controversies and issues surrounding this topic, acknowledging the gaps in our knowledge. Advances in Intervertebral Disc Disease in Dogs and Cats presents up-to-date, reliable information on this common condition for veterinary surgeons, neurologists, and general practitioners.
Radiologists, orthopedic and neurological surgeons present the different minimally invasive methods. Peripheral nerve problems and problems concerning differential diagnosis in special situations such as between radicular and peripheral nerve trunk lesions are discussed, pinpointing the significance of different diagnostic tools. Minimally invasive techniques, utilized nowadays to minimize bone demolition, scarring and risk of recurrence are analyzed. Microdiscectomy is compared with the results of intradiscal techniques, and new methods are discussed facing problems such as epidural fibrotisation, microinstability, osteoporotic or neoplastic or posttraumatic vertebral lesions.
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.