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Thoracic Endoscopic Discectomy

What does “Endoscopic Thoracic Discectomy” mean?

Here is the meaning of each word:

  1. Endoscopic: use of a small fiberoptic tube during surgery to be able to see the inside of the spine.
  2. Thoracic: the part of the spine located in the mid-back.
  3. Discectomy: to remove a portion of a herniated disc.

Altogether, “Endoscopic Thoracic Discectomy” means removing a piece of a disc in the mid-back through a small tube using specialized instruments such as an endoscope.

What is an Endoscopic Thoracic Discectomy?

An Endoscopic Thoracic Discectomy is an alternative to an open surgery, or regular Thoracic Discectomy. The Endoscopic Thoracic Discectomy is done through a small tube, rather than as an open surgery.

Why is an Endoscopic Thoracic Discectomy performed?

An Endoscopic Thoracic Discectomy is done to remove a disc herniation in the mid-back (thoracic spine). The goal is to remove the herniation and take the pressure off the spinal nerve or spinal cord. Usually this procedure is performed for small disc herniations, which are not compressing the spinal cord.

What is the difference between an Endoscopic Thoracic Discectomy, a Percutanous Thoracic Discectomy and a regular Thoracic Discectomy?

    1. An Endoscopic Thoracic Discectomy is performed with a small endoscope through a small metal tube placed through the skin and into the disc.
    2. A Percutaneous Thoracic Discectomy is done through a needle with a small instrument. It may not be able to remove very much disc material.
    3. A regular Thoracic Discectomy is an open surgery with a larger incision.

How is a Thoracic Endoscopic Discectomy performed?                                              

Here are the steps of how this surgery is done:

  1. The surgery is done in an Operating Room.
  2. Before the surgery, an intravenous catheter (IV) is place and antibiotics are given.
  3. The patient is initially placed on the back (supine) and a General Anesthetic is given.
  4. The patient is then carefully placed on the stomach (prone).
  5. The spine is cleaned with a sterile surgical solution (scrub).
  6. An X-Ray machine is used to find the correct spinal disc level.
  7. The doctor makes a small incision over the side of the spine.
  8. A small metal tube is placed through the incision and onto the lamina bone or facet joint area of the vertebra.
  9. A small piece of bone is removed until the spinal nerve can be seen with the endoscope.
  10. The disc herniation under the spinal nerve or spinal cord is then removed.
  11. The tube and endoscope are removed.
  12. The tissue and skin are closed.
  13. A bandage is placed.
  14. The patient is turned on the back (supine) and awoken from anesthesia.
  15. The patient is brought to the Recovery Room.

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

The surgery can take about 1.5 – 2 hours or more to complete.

What is the recovery like from a Thoracic Endoscopic Discectomy?

Here are some of the steps in the recovery from this surgery:

  1. The patient is usually admitted to the hospital overnight.
  2. The incision may take 2 weeks to heal.
  3. Restrictions for activities such as lifting and bending are given.
  4. The patient is usually reevaluated by the surgeon within several weeks.

What benefit can patients gain from a Thoracic Endoscopic Discectomy?

This depends on the symptoms before surgery. Often the benefit from this surgery can be felt within weeks, but it may take months for the spinal nerve to heal fully.