[Endoscopic method for the diagnosis and treatment of spinal pain syndromes]

The endoscopy of the epidural space-"Epiduroscopy"-is a new imaging technique in the diagnosis and therapy of spinal pain syndrome. For investigation of the epidural space either a steerable or controllable flexible endoscope with an outer diameter of 2.5 mm and a working channel or a flexible catheter-secured epiduroscope unit can be used. Epidural anatomic structures, such as the dura mater spinalis, connective tissues, blood vessels, nerve fibers, and adipose tissues could be identified easily. Further it was possible to find pathological structures such as epidural adhesions, fibrosis, and scars. Due to epiduroscopy an epidural catheter could be placed safely in patients with chronic pain syndromes for a continuous intrathecal application of opioids or a precise epidural adhesiolysis. Percutaneous epiduroscopy, a new invasive micro-endoscopic technology, enables the extension of therapeutic potentials in chronic pain syndromes in addition to the diagnosis.