Kaixuan Liu educates patients and offers tips about the benefits of endoscopic discectomy surgery
What is endoscopic spine surgery?
Back pain is a condition that most people will endure at some point in their lives. For chronic back pain sufferers, an endoscopic discectomy, a minimally invasive spine surgery with a rapid recovery time, can often provide relief from unremitting lower back pain when conservative measures have failed, shares Dr. Kaixuan Liu.
A type of "keyhole" surgery using a thin, telescope-like instrument known as an endoscope, endoscopic discectomy requires only a small incision compared to traditional "open" surgery and has become a popular option for pain relief with minimal downtime, Dr. Liu says.
A discectomy is a surgery during which a surgeon removes a herniated disc from the lower back, “aka” the lumbar area. It is done to reduce the pressure on a nerve or a spinal cord. Such pressure can happen due to the natural aging processes – wear and tear, or because of injuries. These can cause a spinal disc to herniate or bulge, which increases the pressure on adjacent nerves, resulting in pain and other unpleasant sensations.
An endoscopic discectomy is basically the same procedure as a lumbar discectomy, but it is performed with the use of an endoscope, a small camera in the form of a metal tube with a light on the end. Such a tool needs a tiny incision and provides a good image and a way for other surgical tools. As there’s no need for additional cuts or damage to bones, the recovery period is shorter and easier. Moreover, there are fewer risks and possible complications.
Usually, endoscopic spine surgery is an option for people who have herniated or bulging discs, and therefore experience pain and other unpleasant sensations such as weakness or numbness. The first option for such a patient is to try conservative treatments, but if there was no visible result, surgery can be recommended.
This surgery can be recommended to those who experience leg pain or numbness, or tingling, which can be worse after sitting or bending. Also, people who don’t feel better after several weeks of conservative treatment can be potential candidates for endoscopic surgery. If the pain didn’t ease after epidural blocks or some tests such as MRI, or CT scan showed a herniated disc, it can be considered as a reason for the surgery.
Remember to consult a doctor if you feel any pain, as early diagnosis can help slow down degenerative processes and prevent serious issues.
Benefits of the endoscopic spine surgery
"Surgery is only considered after all other non-operative measures such as medication, physical therapy and other pain-relieving tactics haven't worked," he explains. "At that point, advanced diagnostic and pain mapping techniques allow us to make an accurate diagnosis of what's causing the pain and determine if endoscopic discectomy can offer relief. For so many who have coped long-term with ongoing lower back pain, it can."
So, the main benefit of the surgery is reducing lower back pain. Endoscopic Discectomy also offers a faster post-surgery recovery time. As the incision itself is very small, the chance of scarring is much less and there’s also a reduced chance of infection.
Here’s the list of all benefits of such a surgery:
- Shorter recovery time
- Reduced scarring
- Less post-operative pain
- Less narcotic drug treatment
- Muscle and spine preservation
- The smallest incision in spine surgery
- Local anesthesia
- Reduced blood loss
- Reduced risk of infection
Types of endoscopic spine surgery
There are several types of endoscopic surgery. The first one is a posterolateral or interlaminar approach. During this procedure, a small incision is made to access the lamina to get access to the spine. This type of surgery offers a broad application, which is especially beneficial as many disorders include neural compression. The second approach is extraforaminal or transforaminal. This approach is used to get access to isolated unilateral foraminal conditions and neural compression. Although, in this type of surgery, there’s a limited capacity.
What conditions does endoscopic spine surgery treat?
Who needs an endoscopic discectomy? Regardless of where it's done on the spine, the procedure is typically used to remove damaged disc material that's causing pain. Dr. Liu states that an endoscopic discectomy is often used to treat:
Bulging discs Herniated discs, Torn discs Radiculitis and/or radiculopathy – types of tingling, pain or weakness radiating from compressed nerves along the spine During the procedure, the endoscope is inserted through a tiny incision and attached to a small video camera projecting an internal view of the patient onto TV screens in the operating room. The surgeon passes small surgical instruments through the incisions, which are typically no larger than a half-inch long, and visualizes the patient's specific disc problem using x-ray fluoroscopy technology. Then the problematic disc or disc fragment is pulled out with a tool known as a grasper or vaporized with a laser.
Conditions treated by endoscopic spine surgery:
- Spinal stenosis
- Foraminal stenosis
- Disc Tears
- Degenerative disc disease
- Bulging disc
- Protruded disc
- Extruded disc
- Herniated disc
- Facet joint syndrome
- Failed back surgery syndrome
- Chronic low back pain
Advantages of an endoscopic discectomy
"Endoscopic discectomy tackles some of the most common causes of lower back pain that severely impact people's quality of life," Dr. Liu says. "In about an hour's time, the surgery is finished, and patients can go home within hours."
Advantages of endoscopic discectomy: In addition to a short procedure time, endoscopic discectomy offers many advantages to patients, Dr. Liu notes. Because muscles moved aside instead of cut, as occurs during open surgery, endoscopic discectomy boasts a much shorter recovery time.
Other advantages include:
- Local anesthesia
- Minimal pain
- Minimal blood loss
- Smaller chance of surgical complications, such as infection
- Minimal scar tissue after incisions heal
- High success rate
- No hospitalization
Any surgery carries risks, and endoscopic discectomy is no different. But these risks are greatly minimized because of the smaller incisions used, Dr. Liu says, and the procedure is successful in 9 of 10 patients.
An endoscopic discectomy is rather safe, as it is minimally invasive spine surgery, but still, there’s always a risk of excessive bleeding or a bad reaction to anesthesia. During the surgery, there can be nerve damage or leakage of spinal fluid. Moreover, even though the risk is lower compared to other invasive surgeries, the incision can start an infection. If the disc tissue wasn’t fully removed, the pain can stay and the patient might need a second surgery.
"The vast majority of patients who undergo endoscopic discectomy for relief from chronic lower back pain achieve this highly desirable goal," he adds. "Lower back pain becomes a distant memory and they return to all their favorite activities." These patients can return home a couple of hours after the surgery.
The recovery is very fast, a patient can walk, but they shouldn’t bend, twist or lift things for a while. It takes about a month to return to normal activities and work.