Endoscopic Spine Surgery and Instrumentation (and Percutaneous Procedures)
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The intervertebral disc, an important supporting structure of the spinal column, is implicated as a major source of low back pain and sciatica. The pathogenesis of disc degeneration and herniation is complex and multifactorial, but clearly outlined and documented by Wolfgang Rauschning’s work illustrating the patho-anatomy of degenerative disc disease and degenerative conditions of the lumbar spine.
Most disc herniations are not the result of an acute event, but an accumulation of several insults to the spine that lead to degeneration, annular tears, and eventual disc herniation. There are several theories of disc degeneration including mechanical, chemical, age-related, autoimmune and genetic. Within the mechanical theory, the following types of abnormal loads have been proven experimentally to cause disc injury: torsion, compression, repetitive compressive loading in flexion, hyper flexion, and vibration.