As millions of people are suffering with chronic back pain because of deterioration of the intervertebral disc from trauma or aging can be cured by moving away from fusion by treating with the pain generator.
Anthony T. Yeung, professor of University of New Mexico School of Medicine has been suggesting endoscopic techniques i.e., minimally invasive technologies and surgical procedures to identify and treat the pain generators with the least invasive, most effective methods available, if non-surgical methods fail.
This recent study of treating chronic low back pain has been published in the Journal of Spine. The surgeon factor is the crucial step to pick the procedures that works best, limited only by their own surgical experience and ability. If non-surgical methods fail, then early surgical intervention has to be adopted for best results.
The transforaminal endoscopic approach is the least invasive approach, performed under local anesthesia with or without sedation. The endoscopic transforaminal technique is not a “see one, do one, teach one” procedure. The Surgeons has to adopt a slow and deliberate timetable to make use of different endoscopic techniques to operate safely.
According to Anthony yeung, Non-fusion technology is the largest area of growth in the treatment of spinal pathology. Intradiscal Therapy focuses on the earliest source back pain, the disc. FDA approved techniques and dynamic stabilization with interspinous implants, nucleus augmentation with hydrogel implants, and biologics round out the fate of intradiscal procedures.
The surgical gaols can be achieved by understanding the pathophysiology and patho-anatomy of pain. Salvage procedures such as fusion has to be used as a last procedure except for gross instability and deformity. Intradiscal decompression and thermal annuloplasty are the starting techniques. Adoption of transforaminal techniques, over 10,000 procedures will provide results that can eliminate the need for fusion for up to 75% of patients who opt to avoid fusion as a first line of treatment, even in the face of mild instability and deformity.