Preface

Nowadays, lumbar spinal endoscopy is well accepted. Not too long ago, its critics scrutinized it for lack of sufficient high-grade clinical evidence to endorse the implementation of endoscopic spinal surgery protocols to treat the common painful conditions of the lumbar spine. Traditionally trained spine surgeons still heavily rely on image-based medical necessity criteria for surgical intervention. These include stenosis, deformity, and instability. In essence, endoscopic spinal surgery replaces these established open lumbar spinal surgery protocols with more targeted miniaturized surgeries that largely ignore these traditional image-based criteria when establishing the indication for surgery. Instead, it focuses on treating validated pain generators, many of which escape detection by conventional advanced imaging studies such as the magnetic resonance image (MRI) scan. It is undeniable even to the untrained bystander that this amounts to a culture clash.

Contemporary Endoscopic Spine Surgery: Lumbar Spine's editors are internationally renowned key opinion leaders with decades of experience in endoscopic spinal surgery. They have come together to develop a multi-authored and clinically focused medical monograph to give the reader a most up-to-date review of modern lumbar spinal endoscopic surgeries. Moreover, they intended to disperse the myth of endoscopic lumbar spine surgery being experimental - a procedure that can only be consistently be mastered by the talented few. Therefore, the editors asked the contributing authors to illustrate their results with the endoscopic lumbar surgery in the context of the peer-reviewed literature by thoroughly discussing the available high-grade clinical evidence. The editors have authored many of these landmark articles that pushed the envelope of clinical research far beyond the initial level of personal opinion and case series reports. They went on to validate them with sophisticated statistical analysis of multi-arm clinical studies.

The publication is intended for Orthopedic Spine & Neurosurgeons interested in treating common painful conditions including herniated disc, stenosis, tumor, and infection with minimally invasive endoscopic techniques. The selection of chapters was based on contemporary trends in lumbar endoscopic spinal surgery. For this purpose, a wide array of highly timely and clinically relevant topics have been assembled based on historical and anatomical considerations. They range from the review of modern transforaminal and interlaminar decompression methods, their hybridized versions, the mobile outside-in approach for far-migrated disc herniations, the over-the-top and contralateral decompression techniques, endoscopic treatment of facet cysts, visualized rhizotomy procedures of painful facet disease, and other denervation techniques of the sinuvertebral- and basivertebral nerve, the application of endoscopic procedures in the elderly, to the illustrative discussion of challenging endoscopic indications and endoscopic and endoscopically assisted fusions. The editors identified these less costly yet safe endoscopic treatments for the lumbar spine's common painful degenerative conditions in response to patients' demand for less burdensome and less risky therapies with a shorter time to recovery and return to work. Contemporary Endoscopic Spine Surgery: Lumbar Spine was written with these goals in mind. The editors hope that the readers will find it an informative knowledge resource they will continue to revert to when implementing a lumbar endoscopic spinal surgery program in their practice setting.