Endoscopic Interlaminer Discectomy Procedure
Endoscopic Interlaminer Discectomy is an outpatient, least invasive procedure performed to relieve low back and leg pain resulting from herniated, bulging, or extruded spinal disc material compressing on the spinal cord or exiting spinal nerves.
Endoscopic Interlaminer Discectomy is a similar surgical approach to a minimally invasive spine (MIS) lumbar microdiscectomy. The main difference between the two is three-fold. First, the endoscopic procedure uses an 8mm or 1/2 inch surgical operating tube versus a 15-25mm operating tube with MIS microdiscectomy. As a result of the smaller 8mm tube the endoscopic procedure is less traumatic on the muscles and surrounding supporting structure of the spine. Secondly, the endoscopic procedure does not require any bone resection unlike the MIS microdiscectomy and with bone resection there is usually more scar tissue formation. Third, the endoscopic procedure uses a 30 degree HD optical scope which affords the surgeon a superior visualization of the disc and surrounding tissue. The end result is a more thorough discectomy. 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 the endoscopic procedure.
Benefits Of Endoscopic Interlaminer Discectomy Versus Traditional or MIS Microdiscectomy
The advantage of the interlaminer endoscopic discectomy procedure is that it only uses a 1/2 inch incision to access the spinal elements and the large muscles in the middle of your back are spared 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
- 1/2 inch Incision – minimizes potential skin scarring
- No muscle or tissue tearing thus less scar tissue and preserve spinal mobility
- No significant blood loss
- Less post-operative pain and need for narcotic medications
- Less recovery time needed
- Return to work sooner
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 general anesthesia and x-ray fluoroscopy, a blunt dilator is placed through the 1/2 inch skin incision through the muscle of the back, laminar window onto the ligament above the spinal nerve and 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 the 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 out disrupting the integrity of the disc as a whole. Once the disc tear is sealed, the metal tube is extracted.
How long is the recovery and how soon can you return to work?
The procedure takes about an hour on average. You normally will feel little, if any pain or discomfort. There are no stitches. Upon completion, a small Band-Aid is placed over the incision. Post-operative, patients usually recover for about an hour and then go home.
Recovery depends on how well you and your body responds to the procedure. Typically most patients will feel better immediately after surgery and go back to work within a week or two. 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.