Endoscopic Discectomy Procedure
Endoscopic Discectomy is the least invasive procedure that we know of that relieves pain from a herniated disc and low back pain. The procedure is performed as an outpatient surgical procedure to remove herniated disc material. The term minimally invasive spine surgery (MIS) evolved due to long post-operative recovery, high infection rates and morbidity involved with open surgery. Although MIS has decreased some of these problems associated with open surgery, MIS still disrupts spinal mobility and has long recovery and out of work times.
Endoscopic Discectomy is different from open or MIS lumbar microdiscectomy, because there is no traumatic back muscle dissection, no bone removal, or large skin incision. The risk of complications from scarring, blood loss, infection, and anesthesia that may occur with MIS or conventional surgery are drastically reduced or eliminated with this procedure. Endoscopic discectomy procedure was invented to be an effective treatment for herniated discs while avoiding these risks.
The advantage of lateral access to the spine with an endoscopic spine procedure, is that is uses a less than ½ inch incision. This in turn, spares the large muscles of your back, resulting in less recovery time.
- High success rates, 90% or above
- Utilizes an HD camera coupled to an endoscope which provides the physician a superior view to that of traditional surgical techniques
- No spinal fusion is necessary thus preserving the spinal column and the disc
- Less than a ½ inch incision minimizes potential skin scarring
- No muscle or tissue tearing thus less scar tissue and preserve spinal mobility
- No significant blood loss
- Conscious sedation reduces the risk associated with general anesthesia
- Less post-operative pain and need for narcotic medication
- Less recovery time needed
- Return to work sooner (as early as 1 week versus 6 weeks with MIS and traditional surgery)
What Conditions Does Endoscopic Discectomy Treat?
- Spinal and foraminal stenosis
- Bulging, extruded and herniated disc
- Failed back surgery syndrome
- Degenerative disc disease
- Sciatica pain
- Radicular pain
- Bone spurs
- Arthritis of the facet or vertebral bodies
How is the procedure performed?
Under local anesthesia and x-ray fluoroscopy, a needle, guidewire and blunt dilator are placed through less than a ½ inch skin incision through the muscle of the back, between the vertebrae into the herniated disc space. A 7mm metal tube is placed over the dilator to create access to the disc. An innovative working channel endoscope is coupled with an HD video camera to enhance visualization for the physician. Through the endoscope, small specially designed microscopic instruments are sent down the hollow center of the endoscope to remove a portion of the offending disc. The procedure also treats disc bulge and annular tears effectively. Inside the disc a tear is debrided of any nucleus and then the annulus is treated with a laser or radiofrequency ablation tool that ablates any painful small nerves that have grown into the annular tear. This effectively shrinks and closes the tear without disrupting the integrity of the disc as a whole. Once the disc tear is sealed, the metal tube is extracted.
The procedure takes about an hour on average. You will likely feel minimal pain or discomfort. The incision is secured with one stitch and bandage. Post-operative, patients usually recover for a few hours and then go home.
Recovery depends on how well you and your body responds to the procedure. Many patients will feel better immediately after surgery. Some patients can go back to sedentary work within a week. Be careful to listen and comply with your physician’s post-operative instructions. Although you may feel better it is best to not do any heavy lifting at all until cleared by your physician.