Similar to a spinal endoscope, an intervertebral foramen is a light-equipped tube that enters the intervertebral foramen from the side or side and back of the patient’s body (either in a flat or oblique fashion) and performs the procedure in a safe working triangle. The procedure is performed outside the disc’s fibrous annulus, and the herniated nucleus pulposus, nerve roots, dural sac and hyperplastic bone tissue can be clearly seen under direct endoscopic vision. The herniated tissue is then removed using various types of grasping forceps, the bone is removed microscopically, and the broken fibrous annulus is repaired with radiofrequency electrodes. The surgical trauma is small: the skin incision is only 7mm, like the size of a soybean grain, bleeding is less than 20ml, and only 1 stitch is needed after the operation. It is the least traumatic and most effective minimally invasive treatment for disc herniation among similar surgeries. Technology Overview Similar to a spinal endoscope, an intervertebral foramoscope is a lighted tube that enters the intervertebral foramen from the side or back of the patient’s body (either in a flat or oblique fashion) and performs the procedure in a safe working triangle. The procedure is performed outside the disc’s fibrous annulus, and the herniated nucleus pulposus, nerve roots, dural sac and hyperplastic bone tissue can be clearly seen under direct endoscopic vision. The herniated tissue is then removed using various types of grasping forceps, the bone is removed microscopically, and the broken fibrous annulus is repaired with radiofrequency electrodes. The surgical trauma is small: the skin incision is only 7mm, like the size of a soybean grain, bleeding is less than 20ml, and only 1 stitch is needed after the operation. It is the least traumatic and most effective minimally invasive treatment for disc herniation among similar surgeries. The treatment principle of intervertebral foraminoscopy is a minimally invasive spinal surgery system consisting of a specially designed intervertebral foraminoscope, corresponding minimally invasive spinal surgical instruments, imaging and image processing systems, etc., to completely remove the herniated or prolapsed nucleus pulposus and hyperplastic bone to relieve the pressure on the nerve root and eliminate the pain caused by nerve compression. The procedure is performed through a minimally invasive spinal surgical system consisting of a specially designed laminoscope and corresponding minimally invasive spinal instruments, imaging and image processing systems. While completely removing the herniated or prolapsed nucleus pulposus, it also removes osteophytes, treats spinal stenosis, and repairs broken annulus fibrosus using radiofrequency technology. Access location 1. For simple disc herniation and partial prolapse cases, the posterior lateral safety triangle approach is preferred. 2.Distal lateral horizontal approach is suitable for central giant herniation. 3. The posterior or interlaminar approach is suitable for free or calcified patients 4. It is suitable for almost all types of disc herniation and some cases of bony stenosis The selection criteria for microdiscectomy with intervertebral foramen or endoscopy are not fundamentally different from those for laminectomy and disc removal. Patients with herniated discs selected for minimally invasive surgery must exhibit signs and symptoms of nerve root compression and must meet the following conditions: 1. persistent or recurrent radicular pain; 2. more radicular pain than lumbar pain. If the symptoms of lumbar pain are greater than leg pain in patients with moderate or less bulging can first do cryogenic plasma meduloplasty; 3, after strict conservative treatment has failed. including the use of steroidal or nonsteroidal anti-inflammatory pain medications, physical therapy, and occupational or condition training procedures, conservative treatment is recommended for at least 4-6 weeks, but immediate surgery is required if there is a progressive worsening of neurological symptoms; 4. No history of substance abuse or psychological disorders; 5. Positive straight leg raise test with difficulty bending; 6. In order to precisely determine the location and nature of the herniated or prolapsed nucleus pulposus, as well as the intervertebral foraminal osteophytes situation, a thorough imaging examination should be performed before surgery, especially CT and MRI are important tools to accurately determine the size, location and nature of the nucleus pulposus. Technical characteristics of foraminoscopy clinical advantages after the introduction of foraminoscopy technology in Shanghai, Shanghai Mu Yang Hospital pain department Professor Lu Zhenhe formed a foraminoscopy clinical-research team, published a clinical report on foraminoscopy in 2010, which concluded that joimax percutaneous foraminoscopy (non-discoscopy) combined with Tessys technology operated independently, successfully implemented for many patients with lumbar disc herniation disc nucleus pulposus removal procedures. The patients were all suffering from lumbar pain and unilateral lower limb radiating pain, which was ineffective after medication and bed rest, and seriously affected their work and life. After thorough preparation, the patients’ pain was relieved immediately by completing the microscopic disc nucleus pulposus removal under local anesthesia via the lateral lumbar approach. After the operation, the symptoms were relieved as normal and the patient was discharged from the hospital within three days. It is understood that this technique removes the herniated disc tissue under endoscopic surveillance through a special lateral intervertebral foramen approach, which is less invasive than the usual posterior approach. A typical laminectomy, in order to approach the target point, necessarily causes extensive damage to structures that play an important role in spinal stability, which usually requires immediate spinal fusion. In contrast, the laminectomy technique gradually enlarges the intervertebral foramen with a patented reamer and appropriate medical instrumentation, completely removing any herniated or prolapsed fragments as well as the degenerated inflamed nucleus pulposus. It also provides continuous irrigation of the lesion to reduce inflammation, uses radiofrequency electrodes to repair the annulus fibrosus, ablates nerve sensitizing tissue, blocks the annular nerve branches, and relieves the patient of soft tissue pain. Compared to other treatments that compare indirect decompression techniques such as mechanical nucleus pulposus excision and decompression, chemical nucleolysis or laser vaporization, foraminoscopic disc removal is a direct technique for targeted removal of herniated disc fragments and decompression of nerve roots. Although the posterior discoscopic technique (MED), which has been widely recognized in recent years, can be used for all types of lumbar disc herniation, its minimally invasive nature is limited because its surgical approach and procedure are the same as that of small-incision open surgery, which requires a paravertebral muscle approach and implementation of a laminar opening with removal of muscle ligaments and bony structures. Foraminoscopic techniques have the obvious advantages of less trauma, less bleeding, easier anesthesia, faster postoperative recovery and less economic burden. Traditional surgery: minimally invasive, minimally invasive, only 6 mm, need to open the vertebral plate, the nucleus pulposus, the wound is about 6 cm, the operation time: shorter, 60 – 90 minutes, safety: safer, clear vision, can effectively avoid the risk of misoperation, prone to wound adhesions, etc., the risk is greater Surgical efficiency: about 97.5% 94.6% Bleeding: minimal, almost no bleeding 90±20ml Pain: painless Slightly painful postoperative analgesic use Local anesthesia, about 10n Spinal anesthesia, about 52n Bed rest time 1 day 7-8 days Hospital stay 3-5 days 17-24 days Postoperative care Easier Basically self-care after 1 day More complicated, postoperative wound drainage, etc., 6 days to sit and stand Recurrence rate less than 3%, almost no recurrence More than 10%, higher recovery time Faster, 3-6 weeks Average 6.5-20 weeks Comparison of minimally invasive foraminoscopic techniques vs. plasma and other techniques Content foraminoscopic vs. plasma, laser, ozone and other ablative surgical indications from cervical to lumbar 5 sacral 1, wide range of indications Part Bulging disc incision size 0.7 cm0.3 cmMinimal traumaMinimal treatment designRemoval of herniated disc, direct purpose, surgical effect consistent with open surgery, wide range of indicationsIndirect decompression of the disc, narrow indications, inexact long-term efficacyAnesthesiaLocal anesthesiaLocal anesthesiaDown to the groundThe same dayThe same dayTechnology maturityGood recovery timeVaries depending on the surgical mediumVisibilityVisibleUnvisibleSurgical time1h -1.5h1h.