Abstract

Endoscopy became very early part of the surgical techniques. In 1807 the first endoscopic procedure was described by Bozzini and 1879 the first working channel endoscope was described by Nitze. Reasons for this developments had been the requirements of the improvement of visualisation in the operation field even at this time. In the neurological surgery the use of endoscops started by L’Espinase in the Brain. As Pioneers acted surgeons like Dandy or Mixter (beside the disc surgery). Cause of technical limits these procedures went forgotten. The open surgery especially on the spine went forward and braught a lot of new techniques, which are now standard and part of residency trainings.At the end of the 80ies the technology for endoscopes made a step forward what leaded to a recovery for the neuroendoscopy. On the spine surgeons like Kampin, who made the first working channel scope for disc herniations, gave a new input.This step was made by the confrontation with disadvantages of open surgery and the goal to minimize the surgical morbidity by using the new techniques of visualisation and surgery.The endoscopic surgery of the spine allows a minimal surgical trauma on the approach, to do surgery only in the region of pathology even under local anaesthesia, avoids postagressive metabolism and gives a fast recovery to the patient. At all it is a minimal aggressive surgery.To do these techniques special skills, trainings and knowledge are required. Also the use of the new technical possibilities must be learned. Meanwhile exist a lot of different endoscopic techniques on the lumbar and cervical spine.Especially the differnet approaches, transforaminal, interlaminar, translaminar on the lumbar spine as well as the anterior or posterior on the cervical spine must be common for an endoscopic surgeon.Nowadays all kinds of discal pathologies beside stenosis can be treated by endoscopy. Diseases like spinal cysts re also a good option for this technique.The value of these techniques has been proofed in a lot of scientific papers till randomized controlled studies beside our dayly experience. The endoscopic surgery of the spine today is a less traumatic and effective option for the surgery of the spine beside the classical microsurgery. There will be further developments of these techniques even to minimalize fusion and stabilisation technology. A proper training of the surgeons from today and tomorrow would be an essential part of an adaequate placement.