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Is Minimally Invasive Endoscopic Treatment the Solution in Spinal Stenosis?


Minimally Invasive in Canal Stenosis; The reason for non-congenital spinal canal stenosis is low back pain that has not been treated well or in time. In particular, sciatica-like pain that hits the legs with recurrent attacks and requires rest should be healed at the initial level.


The spinal motion system consists of disc levels between the vertebrae pairs. Each level of disc and lower / upper vertebrae in the back, called facet joints, provide alignment on the right and left.



Minimally Invasive Endoscopic Treatment for Canal Stenosis


The vertebrae play a role in the alignment and the facets act as a limiter. While the spinal cord passes from the canal limited by the vertebrae and facets to the coccyx, it proceeds by distributing the nerves through the holes called foramen at every level. The spinal canal is in the center where the spinal cord passes, and the foraminal canal is arranged symmetrically on the right and left, limited by the facets.


The most common cause of canal stenosis is the wide-based lumbar hernias occupying the canal, swelling of the facet joints as a result of wear and inflammation, or thickening of the ligaments that limit the canal. These structures narrow the central canal or foramen canal, compress the nerves and cause pain and loss of function (loss of strength and numbness) over time.


Since the canal stenosis progresses very slowly, it is often possible to adapt within decades. Therefore, the diagnosis of canal stenosis at an advanced age without obvious spinal discomfort would not come as a surprise. Slowly progressive stenosis can force the limit of endurance with a small hernia and force to consult a physician.


Treatment is to widen the canal and remove the structures that cause narrowing.


When the facet columns that protect and fix the array are removed during channel expansion, the alignment is continued with metal supports. The relevant level is frozen and the pain is relieved.


The basic principle of minimally invasive treatment is to widen the canal without disturbing the alignment. The structures that create canal invasion are removed with the help of an endoscope, foramens are expanded, the central canal is opened without removing the facet columns. Thus, it is aimed to relieve the pain without the need to freeze the level.


Since canal stenosis is a disease of advanced age, it can be performed without anesthesia and percutaneous endoscopic spine interventions in terms of preventing the negative effects of metal fixation on osteoporotic bones; Choosing foraminoplasty, sublaminal endoscopy decompressions is increasingly common.


Especially in foraminal problems, it will be inevitable to be the gold standard.

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