Technique for CT guided microendoscopic dissection of the spine.

The indications for percutaneous nucleotomy techniques are limited to disk herniation without dislocated free fragments. In cases with free fragments we have developed a new technique for percutaneous sequestrectomy. Under CT and fluoroscopic guidance spinal endoscopy was performed. In the past, percutaneous diskectomies were X-ray-guided with or without endoscopy. In this paper we describe the combination of CT-scanning, fluoroscopy and microendoscopy for guidance of nucleotomes, lasers, microendoscopes and micro-instruments. The technique was performed on 20 patients (17 outpatients) with chronic back pain. To date no major complications occurred. The method offers an effective outpatient treatment of small free fragments and scar tissue in the spinal canal and the foramen.