Endoscopic disc surgery on the lumbar spine
The technique of endoscopic disc surgery
Endoscopic discectomy is an innovative and elegant technique. It avoids skin incisions, the separation of muscles and the removal of bone and facet joints. The endoscopic discectomy is performed through a sleeve, and a large 8mm endoscope with a 4.1 mm working channel. Thus, the almost complete removal of all herniated discs is possible and there remains a barely visible scar. Also, there is almost no scarring within the spinal canal, so that the risk of so-called postdiscektomy syndrome is significantly lower than with conventional microsurgical method.
The technique is performed in very few centers. Through my extensive experience in the field of endoscopy, which I have acquired during my work at the Charité, I am routinely able to apply this method. I would be pleased to advise you that effect.
The transforaminal and the interlaminar approach to lumbar disc herniations
There are basically two different approaches in endoscopic disc surgery. Once from the side through the so-called neural foramen and once through the middle, the interlaminar technique. Which method in a particular case is used, the surgeon decides, depending on the location of the herniated disc and the anatomical conditions. Disc herniations which are located in the neural foramen good for the lateral (transforaminal) approach. But also centrally located disc herninations and larger protrusions, which often cause severe back pain, without pain in the legs, are well suited for this technique. Access through the center is used especially for intraspinal location free sequestered disc herniations.
Examples of endoscopic disc surgery
The selected cases show what is possible in endoscopic disch surgery. For individual problems allways an individual case analysis must be performed than an appropriate treatment plan can be designed.
The postoperative scarring is greatly feared and often the cause of recurrence of symptoms after a pain-free interval of 6-9 months. The treatment of postoperative scarring is often very difficult and frustrating. Therefore, scarring has to be avoided. Scarring is caused as a result of bleeding and tissue destruction. The more minimal the surgery is, the lower the tissue destruction and hemorrhage.