Epiduroscopic trans-sacral approach: Anatomic and technical considerations

Abstract

With advances in optical technology, endoscopy has begun to play an ever-increasing role in the diagnosis and treatment of lumbar pathologic lesion. The technique of Trans-Sacral Epiduroscopic laser decompression (SELD) is very useful in the treatment of small herniated disc, annular tear syndrome, discal cyst and ventral epidural adhesions. We recommend that the surgeon have analyzed the anatomical variation of the thecal end at the beginning of the procedure evident on MRI T1 sequence. The aim of this study presented in this chapter is to determine the anatomical variations in epidural space of lumbosacral area before procedure by MRI for correct placement of epiduroscopy, laser and for a successful operation.