With chronic lower back or neck pain so common that 8 of 10 people suffer from it at some point in their lives, many wonder what happens if they exhaust all treatment options but still haven’t found relief. That’s when Kaixuan Liu, MD, PhD, founder and president of Atlantic Spine Center, begins to consider whether endoscopic discectomy surgery – a minimally invasive procedure with a rapid recovery time – might be the right choice to return patients to a pain-free lifestyle.
Surgery is only chosen after all other non-surgical treatments – including medication, physical therapy and various other so-called “conservative” measures – have failed first. But advanced diagnostic and pain mapping techniques enable not only an accurate diagnosis of what’s causing lower back or neck pain, but pinpoint whether an endoscopic discectomy might solve the problem.
Discectomy is the most common surgical treatment for ruptured or herniated discs, particularly in the lower back, and is also used higher up on the spine, according to national statistics. Endoscopic discectomy, which requires just a small incision compared to traditional “open” surgery, is an increasingly popular option to achieve pain relief with minimal downtime.
“If you or someone you know has dealt with long-term lower back or neck pain, you know how drastically it can affect quality of life,” explains Dr. Liu, who is fellowship-trained in minimally invasive spine surgery. “Endoscopic discectomy surgery is a proven option to quickly get them back to all their favorite activities.”
What patients want to know?
Since few people are familiar with endoscopic discectomy surgery, Dr. Liu must often start from scratch to educate patients about the procedure. Following are some of the common questions from patients.
What conditions can be treated by endoscopic discectomy?
A wide variety of lower back and neck conditions can be treated with this surgery. Regardless of the location, however, the procedure typically is used to remove damaged disc material from the spine that is causing pain.
In the lower back, endoscopic discectomy can treat bulging, torn or herniated discs along with radiculitis or radiculopathy, which are types of tingling, pain or weakness radiating from compressed nerves along the spine. In the neck, it can also treat bulging, torn or herniated discs, as well as brachial neuritis, which is severe shoulder and arm pain, weakness and numbness resulting from compressed nerves.
How is endoscopic discectomy performed?
Endoscopic discectomy is a type of “keyhole” surgery that relies on a thin, telescope-like instrument known as an endoscope. It’s inserted through a tiny incision in the patient’s body and attached to a small video camera that projects an internal view of the patient onto TV screens in the operating room. The surgeon passes small surgical instruments through the incisions – usually no more than a half-inch long – and visualizes the specific disc problem with x-ray fluoroscopy technology. The problematic disc (or disc fragment) is either pulled out with a tool called a grasper or vaporized with a type of laser.
What are the advantages of an endoscopic discectomy?
Because muscles are not cut as in open surgery, endoscopic discectomy surgery boasts a much shorter recovery, with minimal pain and blood loss and a smaller chance of complications like infection. It’s a same-day procedure that gets patients home within hours and creates minimal scar tissue.
Are there any risks to endoscopic discectomy surgery?
As with any surgery, endoscopic discectomy carries certain risks. But these are greatly minimized compared to open surgery, due to the smaller incision used. The most common complication of discectomy, occurring in a fraction of patients, is the possibility of another disc fragment herniating and causing similar symptoms later on. But for almost 90% of patients, endoscopic discectomy surgery is a great success.
What can I expect after endoscopic discectomy surgery?
Here’s something you can’t expect: lots of stitches. There are typically very few stitches with endoscopic discectomy surgery (1 or 2 is common). Most patients experience a marked reduction in their back or neck pain after the procedure, although lingering numbness or tingling may take some time to ebb. Patients are advised to avoid bending, lifting or twisting for a few weeks to minimize a recurrence of a herniation, but afterward are cleared to resume all previous physical activities.
“For the vast majority of patients undergoing this minimally invasive procedure, back and neck pain becomes merely a bad memory,” Dr. Liu says. “It’s gratifying to see them get their lives back.”