A lumbar discectomy is a surgical procedure that is performed to remove herniated disc material from the lower back (lumbar), that is pressing on a nerve or the spinal cord. When this procedure is performed with the use of an endoscope, it is called a lumbar endoscopic discectomy. It is considered a minimally invasive procedure because only a small incision is necessary. In addition, the endoscope (a small metal tube with a camera and light on the end) provides direct visualization through magnified video images, as well as a passage way for the surgical tools, so the patient’s muscles do not have to be torn or cut. As a result of the minimal damage to bone and muscle tissue, most people who have a lumbar endoscopic discectomy experience less surgical trauma, and a quicker recovery period, than those who undergo more-invasive traditional back surgery.
The discs are cushions made of cartilage and other spongy tissue that run between the individual bones of the spine. Through aging, normal wear-and-tear or injury, discs within the lower back may bulge or herniate (rupture), and put pressure on adjacent nerves, resulting in pain, numbness or weakness in the lower back, legs or buttocks. When determining the exact cause of back or leg pain and developing a treatment plan, the physician performs a physical examination to check reflexes, muscle strength and movement. If nerve compression is suspected, additional diagnostic tests may include a CT scan, MRI scan, and a myelogram. An electromyogram and nerve conduction studies may also be performed to help pinpoint the location of the nerve damage.
Candidates for lumbar endoscopic discectomy typically have herniated or bulging discs that produce pain, weakness or numbness that has not responded to conservative methods of treatment such as exercise, stretching, corticosteroids, pain medication or physical therapy. This procedure may also be an option to minimize pain and discomfort in those who have discs that are torn or chronic radiculitis (pain traveling down the leg). A lumbar endoscopic discectomy is often used to treat patients who have progressively worsening numbness or weakness in their legs and/or have serious mobility issues resulting from their condition.
A lumbar endoscopic discectomy has many advantages over traditional back surgery. Benefits of this minimally invasive procedure include:
A lumbar endoscopic discectomy is considered a safe and minimally invasive procedure. As with any surgery, however, there are risks which include:
Patients can generally return home the day of the procedure. Initial pain from the surgery may be treated with pain medication. Patients are advised to avoid bending, lifting or twisting for a few weeks after the procedure. Nerves may take some time to heal and patients may experience some temporary numbness and tingling in the legs. Most patients can return to work about 2 to 4 weeks after the procedure, however those with physically demanding jobs may have to wait longer to return to work. After the recovery phase, most patients experience a significant reduction in back and leg pain after undergoing a lumbar endoscopic discectomy.