What is an Endoscopic Discectomy?
It is a technique in which specialized surgical instruments coupled with an HD camera is utilized to gain access the intervertebral disc. This occurs through a 1/4 inch incision, and does not require extensive dissection of the spinal muscles and soft tissue.
Is there more than one type of Endoscopic Discectomy?
Yes, there is a posterolateral or transforaminal approach (off to the side of the spine) and inter laminar approach (midline). Each have associated benefits and risks and are utilized based on the location of the disc herniation and pre operative surgical plan.
What is the purpose of an Endoscopic Discectomy?
To remove the offending disc fragment with the least amount of trauma to the spine. What separates endoscopic spine surgery from other surgical methods is the ability to avoid creating a future problem such as instability or restructuring of the spine on its way to achieved the goal of removing the disc fragment (pain generator) that is compressing nearby neural elements.
How is an Endoscopic Discectomy performed?
Endoscopic Discectomy is performed as an outpatient procedure. The procedure is through a 1/4 inch incision is made in the skin. Then using a 7mm tube coupled with an HD camera, the problematic space is safely accessed from an angle that avoids the spine. The inflamed part of the disc is visualized and removed. If possible, any visible tears disc in the disc are sealed at that time.
Who performs an Endoscopic Discectomy?
On a national level, Interventional spine and Spine surgeons both perform the surgery. The surgery in itself is technically challenging as three dimensional operating skills need to be exceptional which leads to a steep learning curve. Dr. Bhandary has had the privilege of training with one of the best Endoscopic Spine Surgeons in the country since 2017.
How does an Endoscopic discectomy compare to other forms of discectomy?
When compared to the most frequently-performed standard microdiscectomy, endoscopic surgery is a sufficient and safe supplement and alternative to microsurgical procedures. While maintaining equivalent results to that of microdiscectomy, it is important to realize that with reduced trauma to the surrounding spinal structures this includes structures within the spinal canal. Reduced irritation of structures in the spinal canal and exposure to air (as seen in open surgeries) may lead to less epidural scarring. With less epidural scarring, if needed the approach for revision surgery is less complicated.
What are the benefits of Endoscopic discectomy?
A smaller skin incision is required for access, leading to less trauma of muscles that surround the spine and in turn decreased postoperative pain. Reduced post operative pain, reduces the potential for relying on opioid therapy for pain relief. Some other benefits include:
- Reduced blood loss
- Faster functional recovery
- Preservation of natural spinal motion
- Preservation of the spine if revision operations are required
When can I go back to work?
It depends on the patient, we aim to have patients back to work in a weeks time. Ambulation is begun from the day of surgery, soft back braces may be applied for 4-6 weeks.
Works cited:  Ruetten S, Komp M, Merk H, Godolias G (2008) Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976) 33:931–939