Direct Visualization of Dorsal Nerve Roots of the Cauda Equina by Means of a Myeloscope

An instrument has been devised permitting direct visualization of the nerve roots of the cauda equina by means of a small endoscope. The apparatus is sufficiently small to be inserted readily between any of the lumbar spinous processes, in the same manner as an ordinary lumbar puncture needle. Local procaine anesthesia is used for skin and subcutaneous tissues. A view of the arachnoid membrane, the underlying dorsal roots and their accompanying blood vessels may thus be obtained. In addition, it is usually possible to observe the flow of blood through the veins and arteries of the nerve roots. The instrument was first considered about two years ago, and a rather crude preliminary device, consisting of a cannula and suitable trochars, was constructed. With this instrument it was possible to enter the spinal canal of the cadaver and visualize the lumbosacral nerve roots and their vessels. Observation and illumination were achieved