[From percutaneous nucleotomy with diskoscopy to percutaneous spondylodesis: a new concept emerges]

In the last ten years percutaneous nucleotomy (n = 148) has become a well established, sparing operative procedure in the routine treatment of contained disc herniation. This evolution has been markedly pushed by the most valuable discoscopy. This methodical complement, introduced in 1982 with biportal approach, permits a controlled dorsal decompression of the herniated disc. In correct indications over 80% of favorable results of overall outcome were obtained. With modified instruments, introduced in 1988, also a sufficient preparation of the adjacent vertebral plates for intervertebral fusion has become possible. The preliminary results of this technique - in combination to a temporary percutaneous transpedicular fixation - are encouraging also for optimal musculo-ligamentar compensation of the adjacent functional units.