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The new development and finally the general acceptance of surgical techniques among the worldwide surgical community sometimes create fascinating stories. This is also true for the history of endoscopic lumbar spine surgery. In the last 100 years there was a "natural" evolution of surgical techniques with continuous improvement and "refinement" of lumbar decompression techniques towards less invasive operations with the final "endpoint" of microsurgery. However the application of percutaneous, image-guided, and endoscopic technologies has revolutionized minimally invasive surgery. This article describes the history of endoscopic lumbar spine surgery and its major milestones and protagonists which have helped to make endoscopic lumbar spine surgery "disruptive" minimally invasive surgical technology which has changed the world of lumbar decompression surgery. "The past is the mother of the future"Henri Cartier Bresson, French Photographer, 1908-2004.

Fragestellung: Der Stellenwert der Fusion lumbaler Bewegungssegmente für die Behandlung therapieresistenter Rückenschmerzen bei degenerativer Bandscheibenerkrankung (DDD) ohne Instabilitäten oder Deformitäten wird kontrovers diskutiert. Der endoprothetische Bandscheibenersatz (engl.:[for full text, please go to the a.m. URL], Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2014)

Background: Although histopathological grading systems for disc degeneration are frequently used in research, they are not yet integrated into daily care routine pathology of surgical samples. Therefore, data on histopathological changes in surgically excised disc material and their correlation to clinical parameters such as age, gender or body mass index (BMI) is limited to date. The current study was designed to correlate major physico-clinical parameters from a population of orthopaedic spine center patients (gender, age and BMI) with a quantitative histologic degeneration score (HDS). Methods: Excised lumbar disc material from 854 patients (529 men/325 women/mean age 56 (15-96) yrs.) was graded based on a previously validated histologic degeneration score (HDS) in a cohort of surgical disc samples that had been obtained for the treatment of either disc herniation or discogenic back pain. Cases with obvious inflammation, tumor formation or congenital disc pathology were excluded. The degree of histological changes was correlated with sex, age and BMI. Results: The HDS (0-15 points) showed significantly higher values in the nucleus pulposus (NP) than in the annulus fibrosus (AF) (Mean: NP 11.45/AF 7.87), with a significantly higher frequency of histomorphological alterations in men in comparison to women. Furthermore, the HDS revealed a positive significant correlation between the BMI and the extent of histological changes. No statistical age relation of the degenerative lesions was seen. Conclusions: This study demonstrated that histological disc alterations in surgical specimens can be graded in a reliable manner based on a quantitative histologic degeneration score (HDS). Increased BMI was identified as a positive risk factor for the development of symptomatic, clinically significant disc degeneration., BMC Research Notes, 4, ISSN:1756-0500

Das Ziel der Arbeit lag in der Identifikation von Risikofaktoren für die Entstehung von Rückenbeschwerden im Hochleistungs-Volleyball. Über einen multidisziplinären, quasi-experimentellen Ansatz, wurden anhand einer Stichprobe von 422 Athleten (1. & 2. BL) psycho-soziale, anthropometrische, spielstrukturelle und biomechanische Leistungsparameter erfasst. Bei univariatem Zusammenhang zu Rückenbeschwerden wurden die Prädiktoren im Rahmen einer logistischen Regression kombiniert. Das resultierende Nomogramm liefert ein Tool zur Einschätzung des indiv. Erkrankungsrisikos (12 Monats Prädiktion). Die Arbeit schließt mit dem Vorschlag einer sensomotorischen Trainingsintervention zur Modifikation der Prädiktoren für Rückenbeschwerden im VB. The aim of this thesis was to identify potential risk factors, which are responsible for the evolution of back pain in elite volleyball athletes. Due to a multidisciplinary, quasi-experimental approach, parameters regarding to psycho-social accommodation, anthropometry, biomechanical performance and game structure of a sample of 422 1st and 2nd league volleyball athletes were assessed. The parameters showing a univariate relation to back pain were combined within a logistic regression model. The created nomogram provides a tool to estimate the individual riks of disease (12 month prediction). Concluding, the thesis suggests a sensomotoric training intervention for the modification of the risk for disease of volleyball-specific back pain.