We present our four-year experience with a new minimally invasive method for ambulatory treatment of lumbar discal herniation: micro video endoscopic dissectomy.

Video endoscopic surgery associates microsurgical procedures similar to those used in conventional surgery with a very precise technique. This method was used for 50 patients presenting lumbar disc herniation diagnosed with magnetic resonance imaging using the MacNab criteria, placing priority on the neurological risk of sensorimotor deficit.

Clinical outcome was also evaluated with the MacNab criteria. These patients were able to walk early, resumed work rapidly, and had little lumbar pain and few complications.

Exact knowledge of the site of the lesion, and a better understanding of the traumatic mechanisms have led to a major improvement in the surgical approach used for the treatment of thoracolumbar fractures.

The first reports of a combined anterior and posterior approach recommended a two-week recovery period between the two stages.

It was observed however that the rate of complications was higher and that at the time of the second stage patients had a poor nutritional status which increased the rate of mortality. It was also remarked however that a sequential approach performed on the same day could be achieved.

Recently, the simultaneous anterior and posterior approach was reported by Farcy and others. Their preliminary results indicate that in terms of duration of anesthesia, blood loss, and complications, the simultaneous method is better than the sequential method.

The purpose of our work was to report an analysis of the mechanical and biological benefits of the simultaneous approach for the treatment of thoracolumbar spinal fractures.