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Lumbar Endoscopic Discectomy

What does “Lumbar Endoscopic Discectomy” mean?

Here is the meaning of each word:

  1. Lumbar: the area of the spine located in the low-back
  2. Endoscopic: use of a small fiberoptic tube during surgery to be able to see the inside of the spine.
  3. Discectomy: surgical procedure where a piece of the disc is removed

Altogether, “Lumbar Endoscopic Discectomy” means performing a surgery on the low back through small instruments using an endoscope to see.

What is a Lumbar Endoscopic Discectomy?

A Lumbar Endoscopic Discectomy is a surgical procedure usually done for a disc herniation in the low-back. After making a small incision, a tube is inserted into the spine. Finally an endoscope is placed through the tube to see the disc herniation. Small specialized instruments are used to remove the disc herniation.

Why is a Lumbar Endoscopic Discectomy done?

A Lumbar Endoscopic Discectomy is done for small disc herniations in the low-back which are either pushing (compressing) a spinal nerve or the cauda equina (bundle of nerves below the spinal cord).

What is the difference between a Lumbar Discectomy, a Lumbar Microdiscectomy, a Lumbar Endoscopic Discectomy, and a Lumbar Percutaneous Discectomy?

  1. A Lumbar Discectomy is an open surgery, done with a larger cut (incision) and more of a dissection (moving more of the anatomy aside to be able to see the disc). It is usually done for large disc herniations, complicated disc herniations, or those which put pressure on the cauda equina.
  2. A Lumbar Microdiscectomy is done with a smaller cut (incision) than a Lumbar Discectomy. Small less traumatic retractors and often a Microscope are often used to locate and remove a disc.
  3. A Lumbar Endoscopic Discectomy is done through a small tube which is placed into the spine. A small scope is then placed through the tube to see the disc. This surgery is usually done for smaller, uncomplicated disc herniations.
  4. A Lumbar Percutanous Discectomy is done through a needle. It is usually done for very small disc herniations.

What are the different types of Lumbar Endoscopic Discectomies?

Here are some of the most common Endoscopic Spine Procedures:

  1. Intra-Laminar Lumbar Microendoscopic Discectomy

        What is an Intra-Laminar Lumbar Microendoscopic Discectomy? Here is  what each word means:

  • Intra-Laminar: a procedure done inside the lamina bone of the back of the spine
  • Lumbar: area of the spine located in the low back
  • Microendoscopic: using a very small fiberoptic tube to see the inside of the spine
  • Discectomy: removing part of a herniated disc

Altogether, “Intra-Laminar Lumbar Microendoscopic Discectomy” means removing a piece of herniated disc from the low back using a fiberoptic tube inside the lamina bone.

What is an “Intra-Laminar Lumbar Microendoscopic Discectomy?

This procedure is an endoscopic spine surgery which is done using a different approach than most others. Rather than gaining access to the spine from the side of the spine, the endoscope is placed from the back of the spine.

Small metal tubes are inserted into the spine to create an opening. Finally a larger tube (working channel) is placed which accommodates the endoscope. The endoscopes has channels which allow the surgeon to place instruments into the spine to remove bone, ligaments, and disc material.

      2. Lumbar Discoscopic Discectomy

What does “Lumbar Discoscopic Discectomy” mean?

Here is the meaning of each word:

  • Lumbar: area of the spine locate in the low back
  • Discoscopic: using a specialized fiberoptic tube to see structures in the spine
  • Discectomy: to remove herniated parts of a disc

Altogether, “Lumbar Discoscopic Discectomy” means to remove a portion of a herniated disc in the low back using a specialized fiberoptic tube.

What is a Lumbar Discoscopic Discectomy?

This procedure uses an approach from the back and side (posterior-lateral) of the spine to gain access to a diseased disc. With the help of an X-Ray machine a wire and subsequently metal tubes are placed into the disc. Finally, a larger tube (working channel) is placed and the endoscope advanced through it and into the disc. Small specialized instruments are placed through the endoscope’s channels and disc material removed. Finally, a Laser or Radiofrequency probe is placed to treat the wall of the disc where the herniation occurred.

      3. Lumbar Micro-Endoscopic Discectomy

         What does “Lumbar Micro-Endoscopic Discectomy mean?

Here is the meaning of each word:

  • Lumbar: area of the spine located in the low back
  • Micro-Endoscopic: using a very small fiberoptic tube to see the inside of the spine
  • Discectomy: to remove portions of a herniated disc

       What is a Lumbar Micro-Endoscopic Discectomy?

This procedure uses an approach from the back of the spine to gain access to a diseased disc. With the help of an X-Ray machine a wire is placed into the spine in contact with the lamina bone on the back of the spine. Metal dilating tubes are placed to widen the area. A larger metal tube (working channel) is placed. The endoscope is placed through the working channel. Small pieces of lamina bone and ligamentum flavum are removed until the spinal nerve and dura are seen. The disc herniation is removed while seeing it directly with the endoscope.

 

      4. YESS Endoscopic Disc Decompression

What does “YESS Endoscopic Disc Decompression” mean?

Here is the meaning of each word:

  • YESS: Young Endoscopic Spine System. “Young” is the name of the inventor.
  • Endoscopic: using small fiberoptic tubes to see the inside of the spine
  • Disc Decompression: to lower the pressure in the disc by removing a piece of disc herniation.

      What is a YESS Endoscopic Disc Decompression?

This procedure approaches a diseased disc from the back and side (posterior-lateral) of the spine. With the help of an X-Ray machine a thin metal wire is placed into the disc. A larger metal tube (working channel) is placed over the wire. The endoscope is placed through the working channel into the disc. The inside of the disc is seen with the endoscope and the herniated pieces removed with specialized instruments. Finally, the diseased disc wall is treated with a Laser or Radiofrequency probe.

Are Lumbar Endoscopic procedures only done for Disc problems?

Endoscopic Lumbar procedures are done for the following spine problems:

  1. Lumbar Nerve Compression
  2. Lumbar Spinal Stenosis
  3. Lumbar Foraminal Stenosis
  4. Lumbar Disc Herniation

How is a Lumbar Endoscopic Discectomy done?

Here are some of the steps of how a Lumbar Endoscopic Discectomy is performed:

  1. This surgery is done in an Operating Room.
  2. An intravenous catheter (IV) is placed before surgery and antibiotics are given.
  3. In the Operating Room, the patient is initially place on the back (supine) and a General Anesthetic or Local Anesthetic with Intravenous Sedation is given.
  4. The patient is then carefully placed on the stomach (prone).
  5. The low-back (lumbar spine) is cleaned with a sterile surgical solution and sterile sheets (drapes) are placed around the surgical site.
  6. An X-Ray machine is used to locate the correct level in the spine.
  7.  YESS Endoscopic Disc Decompression and Lumbar Discoscopic Discectomy:
    1. A point on the side of the spine is chosen.
    2. The skin is anesthetized with Local Anesthetic
    3. A small metal wire or needle is placed into the disc with the help of an X-Ray machine.
    4. Over the wire or needle, larger metal tubes are placed onto the disc
    5. A larger metal working channel is placed
    6. An endoscope is placed through the working channel
    7. The inside of the disc is seen and the disc herniation located
    8. Specialized instruments are used to remove the disc herniation
    9. A Laser and/or Radiofrequency probe are placed against the diseased wall of the disc and energy is applied to treat it

       8. Intra-Laminar Lumbar Microendoscopic Discectomy and Lumbar    Microendoscopic Discectomy

    1. The surgeon makes a small cut (incision) next to the spine.
    2. A small tube is placed through the cut (incision) and advanced through the tissue and muscle down to the lamina bone.
    3. The lamina bone on the back of the spine is seen and a small portion removed.
    4. The ligament under the lamina (ligamentum flavum) is now seen and a small portion of it removed.
    5. The spinal nerve and dura (lining of the spinal cord and spinal fluid, which contains the cauda equina) is now seen.
    6. The disc herniation behind the spinal nerve or dura is located and removed with small specialized instruments.
    7. The tissue and skin are closed with stitches (sutures).
    8. A bandage (dressing) is placed on the surgical site.
    9. The patient is turned on the back (supine) and awoken from Anesthesia.
    10. The patient is brought to the Recovery Room.

How long does it take to perform a Lumbar Endoscopic Discectomy?

A Lumbar Discectomy may take 1-2 hours or more to complete.

What is the recovery like from a Lumbar Discectomy?

Here are some of the steps during a recovery from this type of surgery:

  1. This surgery is often done as an outpatient procedure.
  2. After discharge, activity restrictions about lifting, bending, twisting, running, etc. will be given.
  3. The wound will usually heal within 2 weeks.
  4. The surgeon will typically evaluate the patient again within several weeks.

What kind of benefit can patients gain from a Lumbar Endoscopic Discectomy?

A Lumbar Endoscopic Discectomy will remove pressure on the spinal nerve or cauda equina. The symptoms often improve over weeks and months following the surgery.

Depending on how long a nerve was compressed and the severity of the compression, some symptoms may remain.