What is Endoscopic Discectomy?
In our last blog we talked about endoscopic spine surgery, one of the minimally invasive back surgery procedures that have revolutionized spinal care in the last decade. This procedure takes it’s name from an endoscope, a tiny camera at the end of a flexible tube. The endoscope gives surgeons performing the operation a clear view of the area they’re working on. Additionally, very small instruments can be inserted through the flexible hollow tube, obviating the need for cutting with scalpels and other standard surgical instruments, which can cause additional tissue disruption. Here at New Jersey Spine Specialists, our board certified orthopedic spine surgeons have extensive knowledge about these advanced procedures.
As we noted, endoscopic spinal surgery techniques can be used to perform a variety of spinal procedures that previously required invasive surgical techniques. These less advanced procedures can disrupt surrounding tissue and structures, and may add to the risks and complications that are associated with all invasive procedures. In this blog we want to highlight one of the procedures often performed using endoscopic techniques: Endoscopic discectomy. A discectomy is an operation in which a spinal disc – the cushioning pad between the vertebrae – is usually only partially removed. Also called percutaneous endoscopic discectomy, this minimally invasive surgery procedure can be used to treat certain very specific patients with degenerative disc disease, a herniated disc, bulging disc, pinched nerve, and sciatica. During the operation the orthopedic spine surgeon, guided by an endoscope and live fluoroscopic imaging, uses small instruments and sometimes (although rarely) a laser to remove material from the damaged discs that is impinging on a nerve. When a laser is employed, the procedure is called a laser discectomy. Instead of removing the material impinging on the nerve by cutting it away, the laser, theoretically, is supposed to vaporize it. With a reduction in the volume of disc material, there is less outward pressure on the disc wall, which in turn reduces the pressure on the adjacent affected nerve. This may result in a reduction in pain, but there is no guarantee. Laser discectomy may be beneficial for patients with leg pain or radiculopathy resulting from lumbar disc bulges. Further well-designed clinical studies are necessary to confirm the efficacy of laser discectomy versus more standard surgical and microsurgical techniques, which are quite successful at providing pain relief in appropriately chosen patients. Obviously, laser discectomy isn’t right for all back problems, but endoscopic discectomies are another important advance in spinal care and, with future improvements in this technology, it may become more widely accepted and performed more commonly. We’ll be highlighting other advanced techniques in future blogs.