The operative procedure of the endoscopic interventions on the spine such as e.g. on spinal canal stenosis, or on foraminal stenosis is nowadays endoscopic, i.e. minimally invasive and has been practiced for about 20 years.
This technique is used in all spine areas (neck, chest and lumbar spine area) in combination with different access routes and using different, operational-specific endoscopes.
The present state of the art of minimally invasive spinal endoscopy is associated with a standard surgical procedure, as the instruments and methods developed so far require a certain space, including an incision, access, and overall intervention using a general anaesthesia or analog-sedation and corresponding OP environment.
In contrast, spinal endoscopy does not require such an intensive procedure according to the MIBRAR® method and can usually be performed ambulatory, without anesthesia or under local anesthesia or under analog-sedation.
In the case of spinal endoscopy according to MIBRAR®, the great advantages are:
- that the operation can be realized without cutting, through a small needle opening, it can be penetrated into the relevant disc compartment and through the consistent use of micro-dimensional instruments the entire procedure can be performed in a micro-dimensional manner;
- that the MIBRAR® method allows the entire operation to be performed microinvasively by the use of a micro-endoscope equipped with a special high-resolution micro-dimensional optics.
- In comparison to the conventional minimally invasive spinal endoscopy and microinvasive spinal endoscopy according to MIBRAR®, the following should be emphasized.
Basically, for example, a herniated disc can have two causes:
- a traumatically deformed disc;
- or long-term degeneration of the intervertebral disc tissue, which can ultimately be the cause of the extrusion of the tissues.
Especially in the presence of the degenerative intervertebral disc tissue, a recurrence i.e. a new intervertebral disc disease can occur. For the degenerative intervertebral disc tissue represents an existing instability of the segment and this is not cured or eliminated by the sole removal of the intervertebral disc disease.
Another important aspect is the fact that the intervertebral disc compartment in question loses its former shape or height and can lead to other pathologies of the spine.
In such pathologies, further complications may arise, e.g.:
- a spinal canal stenosis,
- a foraminal stenosis,
- a segment instability
- a scoliosis or
- a defect in the sagittal balance
In this context, according to today’s standard methods, long-term measures are inevitable, such as, for example, spondylosis, the use of intervertebral disc prostheses or even a stiffening of spinal segments by the use of screws, titanium, etc.
This, in turn, in many cases causes not only a feeling of strangeness in the non-particulate material, but also the formation of undefined secondary defects over time. For example, the stiffness of the movable spine (rolling over 4-5 floors) can lead to other, unnatural movements (fail-biodynamics) which can now reload and possibly damage the previously healthy regions of the spine.
Spinal endoscopy according to the MIBRAR® method is not only used to remove the symptoms of the intervertebral disk, for example the removal of an intervertebral disc disease, but also – and this is of decisive importance – for the most complete reconstruction and regeneration of the affected segment regardless of the cause of the pathology whether trauma or degeneration. And this can lead to complete restoration of the disc shape, height, and function.
For example, if an inevitable, unclear indication of intervertebral disc resection is present or is exhausted in the event of acute neurological deficits and all the usual conservative or minimally invasive pain therapy methods or blockages, then this problem is to be treated effectively by the MIBRAR® method and goes even an important step further. Using the microinvasive intervertebral disk endoscopy according to MIBRAR®, not only the intervertebral disc disease is removed, but intervertebral and segmental reconstruction is carried out at the same time, and intervertebral disk regeneration is initiated.
This is done with autologous intradiscal transplantation:
- anti-inflammatory factors,
- growth factors and
- endogenous regenerative substances
These body-active substances are extracted from the body’s blood and the subcutaneous fat of the patient directly before the outpatient intervention of the spinal endoscopy after MIBRAR® and processed according to the CGF technology for the subsequent application.
In summary, the advantages of spinal endoscopy using the MIBRAR® method are as follows:
Not only the sequelae (eg, disc herniation), but also the cause (degenerated disc, or chronically or traumatically damaged tissue) is remedied.
The old shape, functionality and resilience of the segment are restored.
The procedure according to MIBRAR® without incision prevents the formation of a larger tissue injury that normally only heals in a week-long process.
In order to effectively perform the reconstruction and regeneration by the body’s active substances, the tissue injury should be minimal so that the regenerative concentrate can be used with the maximum effect for the correlate. For, of course, the mesenchymal cells have the tendency to migrate to the place where they are “used most”. Fresh tissue injury attracts many regenerative factors, with the result that the regenerative effect of the concentrate is largely lost to the original problem (e.g., elimination of the intervertebral disc disease).
It makes a big difference, therefore, whether valuable body-active substances are administered minimally invasively with the formation of a tissue injury or micro-invasively with avoiding a tissue injury. The lower the tissue injury, the more intense is the successful effect of the body’s active ingredients.
In general – as with all outpatient micro-therapeutic procedures according to MIBRAR® – the saving of the anesthesia and the operating costs, which is the case with the usual treatment methods, not only gained a lot of time here, but also the physical stress or the potential risks of a larger procedure are considerably lower for the patient.
The long-term effect differs in that not only the current pain state and the functional problem are solved, but by the pure administration of body-active substances, side effects or possible long-term negative sequences by medicaments, prostheses or other non-particulate materials do not occur. For example, a frequently unknown side-effect of the pain reliever Cortisone, which appears to be helpful at first, results in an increasing weakening of the spinal tissue, which can be the cause of future vertebral damage.
On the contrary: the application of the body’s active ingredients stimulates the active reconstruction and regeneration of the original spine functions until the natural resilience is restored.
Contrary to the conventional treatment methods, which do not rule out possible stiffening of spinal segments, the natural mobility of the spine is not restricted by the natural, regenerative reconstruction by the granting of body-active substances and the stability of the spinal column is not diminished.
Overall, the particularly lasting effect of spinal endoscopy according to MIBRAR® has to be emphasized. Because a unique, outpatient procedure and the awarding of the multifunctional, body-active substances often result in an excellent result with a lasting effect over many years and gives the patient a long-lasting natural quality of life.