Keyhole surgery to minimize disturbance to the spinal canal contents with bloodless laser.
The endoscope is guided along the exiting nerve root, through the foramen and into the anterior epidural space.
The clearing of the anterior intradiscal space can be achieved with the side-firing laser probe Holmium laser and graspers, and disc material can be cleared and an annuloplasty performed to shrink the wall of the disc and reduce a subsequent disc protrusion.
ELF can be also be used to decompress lateral recess stenosis.
Conventional treatment with a fenestrectomy or laminectomy carries an increased risk of scarring that is avoided with ELF.
With disc degeneration and compression of nerves in the lateral recess treated with an open procedure and fusion.
Such fusions currently have a 30% dissatisfaction rate at 2 years and accelerates degeneration in the adjacent discs.
ELF procedure opens the lateral recess, decompresses the nerve roots, and allows micromovements at the segmental level avoiding the acceleration of degeneration at the adjacent levels.
The procedure preserves all surgical options.
The risk of scarring following this procedure is minimal.
Technical advancement allows use of powered reamers, radiofrequency and endoscopes, and the procedure can now be used for multiple additional indications.