Abstract

Purpose of the research: to define the efficiency and capabilities of CT- controlled endoscopic surgery of lumbar disc hernia. Material and method: method has been used since 1998. Endoscopic nucleotomy is being realized in 4 variants: 1. Percutaneous endoscopic lumbar nucleotomy (232 pts). 2. Percutaneous endoscopic transspinal hernioectomy (86 pts). 3. Percutaneous endoscopic lumbar nucleotomy via the axis of the ileac bone (14 pts). 4. Combination of endoscopic nucleotomy and laser decompression (112 pts). Indications and contraindications have been described in detail in literature. The manipulation has been undertaken in an operation room equipped by CT using spinal navigation system. The operation included the following stages: CT discography, the working tube control, endoscopic nucleotomy, post-operation CT. Results: long-termed effects were documented during 8 years after the operation. Excellent and good results were observed in 79 - 32 %, satisfactory results were observed in 10-12 %. Open operations have been performed to 10 - 15 % of patients. Complications: vertebra fracture (2 cases), discitis (3 cases), allergic reactions to local anesthesia (3 cases). Conclusion: CT-controlled endoscopic nucleotomy of lumbar discs is a safe and effective procedure under strict account of indications and contraindications.