Contraindications are outlined in Table 2. To date no serious post operative complication has been reported. Post dural puncture headache Skill, experience and strict regards for sterile technique are essentials to a successful outcome. The patient is placed in the prone position. Strict sterile technique is used throughout the procedure.
Local anesthesia is placed at the sacral cornu.
Fluoroscopy should be available for assistance. A flexible 0.9 mm fiber optic endoscope is placed through and to the tip of a steerable video guided catheter. This catheter houses two working 1 mm channels. Saline solution is gently infused allowing distention of the epidural space. This now enables the endoscopist three dimensional color viewing of the spinal structures and multi-planar maneuverability to pathologic nerve roots encapsulated with adhesions.