Microdecompressive percutaneous endoscopy: spinal discectomy with new laser thermodiskoplasty for non-extruded...

Open spinal discectomy, at times with spinal fusion, is associated with significant local morbidity and long-term convalescence, requires general anesthesia, and involves dissection of muscle, removal of bone, ligament and disc, which are all at greater financial cost. Therefore, the search for a less traumatic spinal discectomy began, including micro-discectomy, and percutaneous techniques and endoscopic discectomy. Lyman Smith reported intradiscal injection of chymopapain in 1964. Onik et al. developed the automated percutaneous discectomy device for continuous aspiration/irrigation of disc tissue in 1985. Hijikata et al also described nucleotomy independently in 1985. In 1986, Ascher and Choy first reported laser discectomy to decrease intradiscal pressure.