ESCAPE : Evaluation of Spinal Conservation by Endoscopic Procedures to Avoid Fusion

ESCAPE : Evaluation of Spinal Conservation by Endoscopic Procedures to Avoid Fusion

The recent development and expansion of endoscopic surgery has made it possible to offer an alternative to this therapeutic escalation. This method allows decompression procedures to be performed using optimized and minimally destructive surgical approaches, which contributes to preserving the physiological function of the lumbar spine and in particular its stability.

The main hypothesis of the research is that the use of endoscopic techniques for decompression of the lumbar spine allows a reduction in the indication for lumbar arthrodesis.

Inclusion Criteria:

• Patient ≥ 18 years old
• Patient consulting for a medical reason involving a spinal pathology in the investigating center :

Syndrome adjacent to an old lumbar arthrodesis defined on preoperative radiographs by an antero-posterior translation > 3 mm, segmental kyphosis > 10° or a disc height reduced by more than 50%, or on preoperative MRI by central stenosis of grade C or D of the Schizas classification or a herniated disc Grade 1 or 2 degenerative spondylolisthesis, i.e. with slippage less than 50% of the depth of the underlying vertebral body.

Lumbar stenosis complicating lumbar scoliosis defined by a deformation with rotation of the vertebral bodies on a frontal radiograph (absence of centering of the spinous process between the two pedicles of the vertebra concerned) and a Cobb angle greater than 20° or a rotational dislocation .

- Indication for spinal surgery by endoscopy

Exclusion Criteria:

• Patient under guardianship or curatorship,
• Persons deprived of liberty by judicial or administrative decision,
• Persons undergoing psychiatric treatment under duress requiring the consent of the legal representative
• Persons unable to express their consent,
• Persons under legal protection,
• Patient not affiliated to a social protection scheme.