Endoscopic Discectomy

Your decision to opt for endoscopic versus traditional discectomy could be enhanced by obtaining a second opinion from experienced spine surgeons.


Endoscopic discectomy is a term to define a minimally invasive technique for removing a herniated disc compressing a nerve resulting in radiating extremity pain, numbness, or weakness.  The term “endoscopic” refers to the use of a long cylindrical tube that is placed relatively atraumatically between muscle fibers overlying the portion of the back to be operated upon.  Rather than making an incision and dissecting herniated discmuscle off of the vertebra to access the area where the disc is herniated, a series of cylindrical tubes are placed over dilators that are placed between muscle fibers, thereby avoiding the need to cut muscle.  In theory, the use of these dilators and cylindrical tubes may limit the amount of muscle damage created during the surgical approach.  The disadvantage of this technique is that it may limit the surgeon’s field of view when looking for fragments of disc material that may have migrated out of the field of view.  There are clear pros and cons when using this minimally invasive technique to perform lumbar discectomy.  The advantages include a potentially smaller incision, less muscle dissection, and a theoretically more rapid recovery.  Disadvantages, as suggested above, include the potential limitation of visualization of the disc herniation and the adjacent nerve to be decompressed, the need for additional x-ray imaging at the time of surgery to ensure proper placement of the cylindrical endoscope, and the reports in the literature that suggest that there may not, in the end, be any shorter recovery when compared against traditional discectomy.  Your decision to opt for endoscopic discectomy versus traditional discectomy could be enhanced by obtaining a second opinion from spine surgeons experienced in both techniques.

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