4 / 8
Page 18
Notes:
Case Rep Surg Invasive Proced 2017 | Volume 1 Issue 3
allied
academies
International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Introduction:
There is a crisis of affordability in spine care
delivery. Interventional pain management, often the first line of
invasive treatment only provides temporary relief that depend
on natural healing to mitigate pain. Visualizing the patho-
anatomy with an endoscope targeting the patho-anatomy,
however, has opened the door for surgical decompression
and ablation of the pain generators. Endoscopic spine surgery
is effective using mobile cannulas to target the pain source.
When a surgeon combines interventional techniques with
endoscopic visualization brings effective steps for surgical pain
management.
Materials & Method:
Endoscopic foraminal surgery (The
YESS) technique is featured. Intra-operative evocative
chromo-discography is performed to confirm discogenic pain;
Intradiscal therapy and visualizing the hidden zone of Mac Nab
identifies 90% of pain generators; Endoscopic foraminoplasty
decompresses the lateral recess and visualizes the exiting and
traversing nerve in the axilla containing the dorsal root ganglion
(DRG) and Dorsal visualized rhizotomy denervates the facet
joint. 10,000 surgical cases illustrate the painful conditions most
suitable for foraminal endoscopic surgery.
Results:
The transforaminal endoscopic technique will allow
surgical access to the lumbar spine for treatment of a wide
spectrum of painful degenerative conditions. There are
conditions where the endoscopic foraminal approach has
advantages over traditional surgical approaches. Discitis; Far
lateral foraminal and extraforaminal HNP, even at L5-S1; Upper
lumbar HNP; Lateral foraminal stenosis and discogenic pain
from toxic annular tears.
Conclusions:
New surgical skills by spine surgeons incorporating
endoscopic spine surgery are needed. The techniques focusing
on intradiscal therapy, disc augmentation, biologics, annular
modulation, and neuromodulation are all well suited for
the endoscopic foraminal approach. This will open the door
to for true minimally invasive access to the lumbar spine
without affecting and destabilizing the dorsal muscle column.
Formal training or mentorship will bring make this technology
mainstream.
Speaker Biography
Yeung A specializes in diagnosing and treating the patho-anatomy of back pain
and sciatica from painful degenerative conditions of the lumbar spine, particularly
discogenic pain from toxic annular tears, disc herniations, lumbar spondylosis and
foraminal stenosis. His Endoscopic procedures are over 10,000 since 1991 are effective
in relieving both back and leg pain, by visualizing, decompressing, and ablating the
pain generator with an endoscope. He is the developer of the Yeung Endoscopic
Spine System, and has interest in developing a robotic and image guidance system to
facilitate his technique for spine surgeons in training.
e:
ayeung@sciatica.comAnthony Yeung
Desert Institute for Spine Care, USA
Surgical pain management by
in-vivo
endoscopic visualization of pain generators in
the lumbar spine