Which are the most frequent full-endoscopic lumbar approaches ?
There are thRee main approaches in endoscopic lumbar spine surgery.
Trans-foraminal
Inter-laminar
Extra-foraminal
Please note that de name of the approach actually describes the trajectory of het endoscope and NOT the anatomic localization of the pathology.
Eg. an foraminal disc herniation is most often approached with the extra-foramina approach.
Trans-foraminal approach
This approach is mostly used for acces to the spinal canal to decompress a spinal nerve by resection of a disc herniation. Since the working channel is fixed in the lower neuro-foramen there is is limited mobility for the endoscope. High or low migrated disc fragments can sometimes not be reached. Only pathology in the spinal canal wich is not lower than the upper border of the inferior pedicle and the middle of the superior pediclel can be correctly removed.