The Yeung Percutaneous Endoscopic Lumbar Decompressive Technique (YESS TM )

Endoscopic spine surgery is receiving intense interest as minimally invasive techniques, robotics and biologics are the latest focus in spine care that is embraced by a myriad of providers, all touting their area of expertise as the answer to treating painful conditions of the spine. All stakeholders agree that if non-surgical methods of treatment are effective, the natural adaptation of painful degenerative conditions will eventually be mitigated or resolved with some modification of work or activities of daily living that avoids aggravating the clinical condition or delays a rapid advancement to a painful condition. Each stakeholder in the treatment spectrum is touting, and marketing their areas of expertise, but few stakeholders work together in a truly multidisciplinary and cooperative agenda. Procedural or surgical interventions are easiest to market and to measure its efficacy and cost effectiveness. The cumulative cost of spinal care is, however, becoming less affordable as spinal care does not follow the economics of a free market since increased consumption and availability does not result in decreased cost as an economic model. There is a need for cooperation and a focus on the diagnosis and treatment of common painful conditions of an aging spine, starting with common back pain that affects tens of millions of patients. Back pain is one of the most costly and debilitating conditions universally affecting work productivity. In the United States and in industrialized countries, new procedures for back pain tend to “follow the money” aided by industry. In Asian and OUS countries, there is more acceptance of traditional non-surgical treatment from thousands of years of medical treatment history. New and non-traditional treatments based on evolving science, are being made readily available in the information highway by Open Access Journals where researchers can publish their Level V evidenced based concepts for interested parties and other scientists. Anthony T. Yeung’s work focuses on the surgical treatment of the pain generator in the lumbar spine. Patient selection is aided by using diagnostic and therapeutic injections, to identify the likelihood of surgical success when the pain source is targeted. This article focuses on the details of Yeung’s 27 years’ experience on identifying and treating the pain generators in the lumbar spine by an endoscope and combined with an endoscopic system that he has trademarked the Yeung Endoscopic Spine System (YESSTM).