Endoscopic Treatment of Herniated Discs

by Carl Spivak

Unfortunately, the spine suffers wear and tear as people age. This process is known as degeneration. Degeneration is usually first seen in the discs of adults in their thirties to fifties.  The annulus, the thick fibrous cartilage that surrounds the interior of the disc, may weaken. This allowing the nucleus that makes up the interior of the disc to overflow, which forms a bulging disc.  If the annulus tears, the nucleus may squeeze out forming a herniated disc. The disc may compress or “pinch” spinal nerves, causing the back and leg pain, numbness, tingling and weakness known as sciatica. This pain may be worsened or maintained by inflammation around the nerve roots in the spine.

Possible risk factors for ruptured discs are injury, smoking, pregnancy, jobs involving heavy lifting, repetitive lifting and twisting, or operation of heavy vehicles.

Patients who are not helped by more conservative treatment may benefit from surgery. Traditional surgery is destructive to the spine.  The larger the incision the more damage to skin, muscle, ligaments and bone. This collateral tissue damage may result in more pain, muscle weakness, spinal instability and scar tissue which could lead to future difficulties.

Minimally invasive surgery involves a skin incision of less than one inch, but it is more than just a small incision. The surgery is done through a tube that slides in between back muscles to decrease the muscle damage and weakness caused by muscle retraction.  As noted earlier, this is not the same as “microsurgery”, which only refers to surgery that involves the use of a microscope, not the size of the incision or the amount of muscle damage.

Endoscopic spine surgery is state-of–the-art minimally invasive spine surgery. During an endoscopic discectomy, a micro video camera is inserted through a very small incision to locate the disc that is pinching the nerve.  The camera projects the images onto a video screen so the surgeon can easily visualize the compression. Tiny instruments are inserted through the camera to decompress the nerve, relieving pain and suffering.  The advantages of this type of surgery include no general anesthesia, a very small incision, minimal post-operative pain, and a shorter recovery then traditional surgery.

The endoscopic discectomy is an excellent choice for someone suffering from recurrent disc herniation after traditional discectomy because it avoids most of the old scar tissue. This decreases the chance of spinal dural tears and spinal fluid leaks. Traditional discectomy is done through a midline incision.  A second surgery must deal with the scar tissue from the first operation, increasing risk of complications.  Endoscopic surgery is done from the side of the spine instead of the rear, avoiding most scar tissue and potential problems.

If you have been suffering from chronic back pain due to bulging or herniated discs, an endoscopic discectomy might help. Find out if you are a candidate for minimally invasive treatment by making an appointment today.

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