Spine Endoscopy: Endoscopic Discectomy for slipped disc and sciatica
Endoscopic Discectomy is a minimally invasive spine interventional technique that utilizes an endoscope to treat herniated disc, protruded disc or disc bulge, extruded, or degenerative discs that are a contributing factor to leg and back pain.
Since we don’t have to cut the muscles and bones to open the entire spine, spine endoscopy has shown to be a boon for patients with spine problems. With the advancement in technology using 3 Chip camera and 4K monitors, now we can see each and every structure inside with more clarity and thus can avoid injury to important structures. At IPSC, we have best of the equipment’s for your safety and efficacy of the procedure.
Endoscopic Discectomy is a minimally invasive spine surgery technique that utilizes an endoscope to treat herniated, protruded, extruded, or degenerative discs that are a contributing factor to leg and back pain. Spine endoscopy or Endoscopic discectomy is required for cases of slipped disc or disc bulge where your protruded disc is compressing the nerves.
Our lower back has multiple bones called vertebrae and in between two vertebrae, there is a cushion called intervertebral disc. Around the disc, there are nerves which start from the spinal cord and goes down to the legs.
When the disc ruptures or bulges out, it compresses the nerve and your pain starts going down to your legs which is called radiculopathy or sciatica.
More than 70% of the patients usually don’t need any additional procedure. In some cases even after removing the disc, there may be some swelling on the nerves left which can be dealt with a minor procedure after 2 weeks. Although reherniation is rare, but it is possible if we don't take proper precautions after endoscopic discectomy. IPSC protocol usually advise 4 weeks of lumbar support belt after the procedure, along with some restriction of activities like prolonged sitting, forward bending, and weight lifting.
It takes 4-6 weeks for the disc to become normal. From the skin, you won’t feel anything but the inside tissue takes time to heal. Although, we encourage patients to start walking after 1-2 days of rest, but certain precautions like forward bending, lifting heavy weights, pushing heavy objects, sudden twisting movements, are must.
The purpose is to remove the pressure off the nerve which have compressed the nerves because of disc herniation and bulge. Prolonged compression of the nerve may lead to permanent loss of the functions of the nerve.
You may feel pain and paraesthesia, pins and needles. There may be loss of sensation in some part of the leg and at times, even weakness in the lower limbs.
We make a small hole on the skin under local anaesthesia and infiltrate the entire track up to the disc with local anaesthesia. Patients are awake throughout the procedure and this adds safety to the procedure as we can detect any touching to the nerve while removing the disc.
Through this small hole we insert the spine endoscope which is fitted with camera. Through this camera we can see inside, on our screen. Once we reach the herniated material or the bulging part of the disc, we start removing it without disturbing the normal disc and other tissues.
Since we don’t cut the bones and other important tissues of the spine to reach the bulging part of the disc, no rods and screw and fixation is required after endoscopic discectomy.
No Interventional procedures are 100% safe. Though the chances of complications are rare but the chances of infection, bleeding and nerve trauma are there. All these complications can be managed, if they do happen. As compared to open surgery, endoscopic spine procedure is much safer for slipped disc and sciatica.
No! Spine endoscopy or Endoscopic discectomy is required for cases of slipped disc or disc bulge where your protruded disc is compressing the nerves. When the disc compresses the nerve, your pain will start going down to your legs which is called radiculopathy or sciatica.
Usually we advise conservative treatment in the form of medications, physiotherapy in selected cases and some exercises after examining the patient. If the condition is not urgent, we usually wait for 2-4 weeks. But, in cases where the disc herniation is large and compressing the nerves, it is advised to get it removed as soon as possible. Compression of the nerves for longer duration, may lead to irreversible damage to the nerve. In these cases, patient may develop foot drop or muscle weakness or some neurological deficit.
If there is a major loss of function like loss of bladder and bowel control, loss of limb movements, sense less leg, in such cases we do open surgical discectomy.
In patients with some numbness or tingling, we can safely go for endoscopic discectomy.
No. We only remove the protruded part of the disc. By selectively removing that bulging part, we relieve the nerve off the pressure.
Although rare, but it is possible if we don't take proper precautions after endoscopic discectomy. We usually advise 4 weeks of lumbar support belt after the procedure, along with some restriction of activities like prolonged sitting, forward bending, and weight lifting.
No. That is not required in the endoscopic procedure. In fact, we preserve even the normal disc which is close to protruded disc. This prevents the collapse of the disc in future.
Yes. We make a small hole on the skin under local anaesthesia and infiltrate the entire track up to the disc with local anaesthesia. Patients are awake throughout the procedure and this adds safety to the procedure as we can detect any touching to the nerve while removing the disc.
Complications are possible but rare with this technique as compared to open surgery. The possibility of nerve injury, bleeding, and infection at the site are there and in most cases are manageable.
Yes, it is covered but one day admission is required for insurance purpose. At IPSC, for non-insurance patients we do this procedure as a day care and we discharge them after 4-6 hours of observation.