Anterior epiduroscopic neural decompression: Eight-center experience in 154 patients

Erich O. Richter, Marina V. Abramova, Fernando Cantu, Jose DeAndres, Peter Lierz, Pier Luigi Manchiaro, Jean Pierre Van Buyten, Jae Do Kim, Jae Ho Jang, Gu Hee Jung, Ji Youn Kim, Su Jin Jang, Hector Salgado, Peter Salgado, Kenneth M. Alo

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


In recent years, technical advances have allowed more significant structural spine surgery through small access portals. Minimally invasive spinal surgery (MISS) is commonly thought of as posterior approaches using muscle dilating tubular retraction systems, but these approaches are best suited to a single spinal level and require bony disruption at each level treated. Access through the sacral hiatus with a flexible endoscope allows an alternative, longitudinal approach to the entire lumbar epidural space. Surgical instruments can be introduced through the endoscope, including laser waveguide fibers. In this article, we expand upon previous reports and describe the combined clinical results of endoscopic laser decompression in 154 patients from 8 centers. All cases of anterior endoscopic neural decompression via sacral laminotomy between December 2009 and May 2011 were reviewed at participating centers and sent a follow-up questionnaire. One hundred and fifty-four cases were identified. There was a significant improvement in disability caused by low-back and/or leg pain as measured by the RMQ. The postoperative level of pain improved from 7.5 to 3.4. By the MacNab scale, success was achieved in 82%. Overall, the patients demonstrated significant clinical recovery and improvement in both quality of life and overall pain levels.

Original languageEnglish (US)
Pages (from-to)401-407
Number of pages7
JournalEuropean Journal of Pain Supplements
Issue number2
StatePublished - Nov 2011


  • Back pain
  • Decompression
  • Endoscopy
  • Epidurogram
  • Epiduroscopy
  • Laser
  • Minimally invasive
  • Sacral hiatus

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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