By Alberto Alexandre, Marcos Masini, Pier Paolo Maria Menchetti

Radiologists, orthopedic and neurological surgeons current different minimally invasive equipment. Peripheral nerve difficulties and difficulties bearing on differential prognosis in targeted occasions similar to among radicular and peripheral nerve trunk lesions are mentioned, pinpointing the importance of other diagnostic instruments. Minimally invasive recommendations, applied these days to reduce bone demolition, scarring and chance of recurrence are analyzed. Microdiscectomy is in comparison with the result of intradiscal ideas, and new equipment are mentioned dealing with difficulties corresponding to epidural fibrotisation, microinstability, osteoporotic or neoplastic or posttraumatic vertebral lesions.

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Extra resources for Advances in Minimally Invasive Surgery and Therapy for Spine and Nerves

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Spine surgery-applied technology has been developed at neck breaking speed, including radiolucent tables that allow ideal positioning of the patient, intraoperative images in real and virtual time (tomography, fluoroscopy, MRI, Philosophy and Concepts of Modern Spine Surgery 25 Fig. 2 The knowledge from static to dynamic images, from real to virtual images, from diagnostic to therapeutic images Fig. ) [11, 13] and sophisticated instruments for separation, retraction, coagulation and implementation of devices in order to achieve the surgical objectives through small existing anatomical sites and from the skin outer surface (Fig.

The association with ozone injection is probably the explanation for our long lasting results after 2 years of follow-up. M. Masini and A. Calac¬ła Oder et al. [14] studied the nucleolysis with ozone combination with steroids and analgesics in 620 patients with lumbar pain. They also confirm the sustainable results with significant pain relief mainly in patients with bulging discs. Muto et al. [12] in 2008 reported their experience with 2,900 cases of patients treated by discolysis with O2/O3 intradiscal, periganglionic and periradicular injection.

This technique has the merit of being able to remove not only contained herniation, but also extruded or even migrated fragments of the disc. Additional advantages, compared to microdiscectomy, are that the procedure avoids any damage to the paravertebral muscles and excision of the posterior bony elements of the spine, particularly the articular processes, and that only a limited portion of the intervertebral disc is removed thus preserving to a large extent the integrity of the disc. 20 An alternative endoscopic procedure can be performed by posterior approach with dilators of different diameters introduced into the paravertebral muscles to reach the laminae, which are partially excised to gain access to the spinal canal [21].

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