Observation of Spinal Canal and Cisternae with the Newly Developed Small-diameter, Flexible Fiberscopes

Epidural Lysis of Adhesions: Percutaneous and Endoscopic Techniques

“…Fluoroscopy was used in conjunction with their technique which aided in identifying the spinal level in view. Signi fi cant anatomical fi ndings including aseptic adhesive arachnoiditis and clumped nerve roots were also visualized with the use of this new technology [ 39 ] . Epiduroscopy may be useful in con fi rming a physiological basis for radiculitis when other diagnostic studies such as MRI are negative [ 37 ] .…”

Recent advances in epiduroscopy

“…He improved the design of the myeloscope and described the structures he observed in the epidural and subarachnoidal spaces in detail. In 1986, Blomberg [3] visualized the dorsomedian connective tissue band in a human cadaver, and in 1991, Shimoji et al [4] visualized the spinal canal and cisterna in humans. These procedures were performed by the traditional posterior spinal approach, either midline or paramedian.…”

“…It was as late as 1986 when Blomberg visualized the spinal canal in a human cadaver by the conventional posterior spinal approach [3]. In 1991, Shimoji et al visualized the subarachnoid space and the cisterna [4]. The conventional approach, either through the posterior-spinal, i.e., midline or the paramedian, approach made it difficult to maneuver the epiduroscope because of the angled insertion.…”

Exploring the brain and spinal cord by a fine flexible fiberscope

“…Since we demonstrated the feasibility of inserting a fine flexible fiberscope through the lumbar spinal tap method to the human cisterna magna and cerebral ventricles in 1988 [1], 1991 [2] and 2009 [3,4], there have been no further developments in this new method, seemingly due to the difficulty in manipulating techniques and manufacturing so fine flexible fiberscopes, except the similar work by Layer et al [5]. They, however, used the guide wire for insertion of the fiberscopes, which could cause the damage to the spinal cord or brain.…”

“…Second, the fiberscopes are fine and flexible enough to float easily in the cerebrospinal fluid (CSF). Even when the fiberscope hit the roots or vessels in the CSF, it slips out of those structures without causing any discomfort in all 25 patients except 6 abandoned cases with chronic arachnoiditis [2]. Third, all the procedures were carried out in patients during wakefulness and instructed beforehand to inform any discomfort or dysesthesia during the procedures.…”