MINIMALLY INVASIVE APPROACHES AND SURGICA L-PROCEDURES IN THE LUMBAR SPINE

The history of minimally invasive lumbar spine surgery began in 1963 w ith the introduction of chemonucleolysis. Like this technique, the lat er development of mechanical nucleotomy and lasernucleotomy aimed prim arily at reduction of the disc pressure. Miniature optical systems off ered the opportunity for more specific decompression by discoscopy or, more recently, by transforaminal epiduroscopy. Initially, nucleotomy was the only feasible minimally invasive procedure. In recent years, h owever, minimally invasive spinal fusion became possible due to the de velopment of new devices (Cages) and advanced transperitoneal (laparos copic) and retroperitoneal approaches.