Endoscopic Laser Foraminoplasty: A Treatment Concept and Two-Year Outcome Analysis

Conclusions

This series of endoscopic laser foraminoplasties represents the initial attempt to address degenerative disc disease of the spine, lateral recess syndrome, and failed back surgery as a complex of multiple sources of pain production. That so little tissue handling could do so much to so many who had no alternatives available brings into focus once again our lack of understanding of back pain and our persistent overkill, relying on major potentially damaging surgical procedures such as instrumented or noninstrumented fusions to treat such pathology. The principal cause for the failure of conventional spinal surgery is attributed to “operating on the wrong level.”¹⁸ Viviprudence and endoscopy in-dicate that the cause of failure is in reality a failure to identify not only the level, but the pain site in the level.