en Minimally Invasive Pain Procedures Basic Science Basic Science Letter/Editorial Letter/Editorial <p>Preserving normal tissue during surgery has become increasingly important for better outcome after operation. Because of this, minimally invasive procedures have been developed. There are many pain procedures with minimally invasive method to aid fluoroscopy.</p> <p>The percutaneous vertebroplasty or kyphoplasty instead of screw fixation for many kinds of compressed fractures with 90% success rate is a good example (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R1&quot;>1</xref>). The percutaneous radiofrequency ablation of medial branch of dorsal ramus for facet mediated vertebral pains is another example with good results (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R2&quot;>2</xref>).</p> <p>The percutaneous trigeminal ganglion radiofrequency ablation instead of microvascular decompression in elderly people has success rate of 80% - 90% (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R3&quot;>3</xref>). Spinal column stimulator and intrathecal pump implantation are expensive and useful methods of treating persistent pains such as failed back surgery syndrome and CRPS (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R4&quot;>4</xref>).</p> <p>Recently, the percutaneous transformational decompression of disc with ozone or laser or coblation in bulging or moderate protrusion of lumbar or cervical discs or in disco genic pain instead of discectomy or screw fixations, have become popular. In 1973, Kambin (originally Iranian orthopedic surgeon) started percutaneous decompression of disc by nucleotomy in USA (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R5&quot;>5</xref>). Later, he reported 72 percent success rate with modified Hijikata approach (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R6&quot;>6</xref>). In 1985, Onik et al. introduced nucleotomy with motorized shaver (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R7&quot;>7</xref>). Ascher performed the first laser discectomy in mid-1980s. He used Nd: YAG laser and the good to fair range response to that method was 78% (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R8&quot;>8</xref>).</p> <p>Minimally invasive percutaneous transforaminal endoscopic discectomy was initiated by Kambin in 1988. Kambin described The triangular safe zone in transforaminal approach in 1990 (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R4&quot;>4</xref>). Tsou and Yeung, in 2002 , reported the same efficacy for endoscopic discectomy and conventional open surgery (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R9&quot;>9</xref>). They reported 91% success rate for this approach (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R10&quot;>10</xref>). Nevertheless, there are some failed cases such as migrated fragments or high canal compromised herniation (<xref ref-type=&quot;bibr&quot; rid=&quot;A39016R11&quot;>11</xref>).</p> <p>With recent advances, endoscopic discectomy will gradually replace open discectomy in near future.</p> Minimally Invasive Pain Procedures,Surgery,Endoscopic Discectomy 100 110 http://annbsurg.iums.ac.ir/browse.php?a_code=A-10-31-180&slc_lang=en&sid=1 Mohieddin Fasihi Harandi 1003194753284600402 1003194753284600402 Yes Anesthesia and Pain Department, Milad Hospital, Tehran, IR Iran