Lumbar Endoscopic Discectomy

Lumbar endoscopic discectomy (LED) is a minimal invasive surgical procedure employed for the removal of the damaged portion of the intervertebral disc responsible for lower back pain. LED is an advanced surgical technique that employs X-ray imaging and video guidance to navigate the endoscopic probe to the herniated disc space.

The benefits of lumbar endoscopic discectomy over the traditional open surgery include:

• Minimally invasive
• Less blood loss
• Operated under local anesthesia
• More precise with a high success rate
• Small incision and rapid recovery
• Discharged on the same day
• Does not affect the spinal mobility

Lumbar endoscopic discectomy is employed in the management of various spinal conditions such as herniated disc, disc tear, radiculitis and radiculopathy affecting the lumbar region of the spine. LED is recommended for lower back or buttock pain persisting beyond 10-12 weeks, or similar pain not responding to conservative treatments such as physical therapy, chiropractic care, acupuncture, medications and spinal injections. LED is also recommended in the patient with nerve root compression or irritation.

Procedure

Lumbar endoscopic discectomy surgery involves the following steps:

• Patient is placed on the operation table and a local anesthesia is administered at the lumbar region
• A small metal tube (portal) is then inserted in the affected lumbar region, under fluoroscopic guidance. This tube serves as a transit for the surgical tools, which avoids the need to cut muscles as in open discectomy
• A tiny camera or endoscope is also inserted through the portal which helps to visualize and evaluate the condition of the damaged spine
• With the help of X-ray fluoroscopy and enlarged video images, pieces of the herniated disc are precisely removed with a grasper
• Conditions such as disc bulge and annular tears are treated with a laser
• The laser vaporizes the disc material as well as consolidates the disc, preventing any further leak of the disc material to the surrounding nerves
• Finally, after the procedure, the tube is removed and the incision is sutured

Post-operative care

The majority of patients experience immediate pain relief, after the surgery. The patient is discharged home the same day of the surgery. Some patients may experience post-operative pain, due to muscle spasms, which may persist for a few days. Your doctor may prescribe medications such as muscles relaxant and pain killers or advise heat application for the management of this pain.

Risks

Risks and complications associated with LED surgery are comparatively low. Some of the potential risks include bleeding, infection, leakage of the spinal fluid, nerve injury and recurrence of disc herniation involving some other disc.