Endoscopic Lumbar Microdiscectomy
What is Endoscopic Lumbar Microdiscectomy?
Endoscopic Lumbar Microdiscectomy is a minimally invasive surgical procedure used to treat herniated discs in the lumbar spine (lower back). It is performed through a small incision, using an endoscope (a small, flexible tube with a camera) to visualize the disc and surrounding structures. The goal of the procedure is to remove the part of the herniated disc that is pressing on nearby nerves, causing pain, numbness, or weakness.
This procedure is often recommended for patients who have:
A herniated disc in the lower back (lumbar spine)
Sciatica (pain radiating down one or both legs)
Nerve compression due to disc bulging or rupture
Chronic back pain that has not improved with conservative treatments (such as physical therapy or medications)
Endoscopic Lumbar Microdiscectomy is a minimally invasive technique that typically results in smaller incisions, less muscle dissection, and a faster recovery compared to traditional open surgery.
Indications for Endoscopic Lumbar Microdiscectomy:
Endoscopic Lumbar Microdiscectomy is typically recommended for patients who have:
A herniated or bulging disc in the lumbar spine that is compressing a nerve root
Pain, numbness, or weakness in the legs (sciatica)
Failed non-surgical treatments, such as medications, physical therapy, or epidural injections
Persistent or worsening symptoms that interfere with daily activities
The procedure aims to relieve nerve compression, reduce pain, and improve mobility.
Procedure Overview:
Incision: A small (about 1-inch) incision is made in the lower back near the herniated disc. This incision is much smaller than those used in traditional open surgery.
Endoscopic Insertion: A small tube (endoscope) with a camera is inserted through the incision, allowing the surgeon to view the disc and surrounding tissues on a monitor.
Disc Removal: Using specialized instruments, the surgeon removes the herniated portion of the disc that is pressing on the nerve root. This step helps to relieve pressure and alleviate symptoms like pain, numbness, or weakness.
Closure: After the disc material is removed, the small incision is closed with a few stitches or surgical glue. There is no need for a large incision or significant muscle disruption, leading to a faster recovery.
Pre-Surgery Instructions:
Medications: Inform your surgeon about all medications you are taking, including blood thinners and over-the-counter drugs. You may need to stop certain medications before surgery.
Fasting: Do not eat or drink anything after midnight before your surgery. This is important to ensure your stomach is empty during the procedure.
Pre-Op Testing: Your doctor may order blood tests, X-rays, or an MRI to evaluate the herniated disc and the surrounding structures to determine the best approach for surgery.
Quit Smoking: If you smoke, you may be advised to stop before surgery. Smoking can slow the healing process and increase the risk of complications.
Post-Surgery Care:
Hospital Stay: Most patients go home on the same day of the surgery.
Pain Management: Some discomfort, soreness, or mild back pain is common after surgery. Your surgeon will prescribe pain medications to manage this. Over-the-counter pain relievers may also be recommended.
Activity Restrictions: Avoid lifting heavy objects, bending, and twisting for several weeks following the procedure. Gradual return to normal activities will be advised based on your recovery progress.
Physical Therapy: Physical therapy may be recommended to help strengthen the back, improve posture, and increase flexibility. Your doctor will provide specific exercises to help with your recovery.
Incision Care: Keep the incision clean and dry. You will be provided with instructions on how to care for the site and when it is safe to shower. Watch for any signs of infection, such as increased redness, swelling, or drainage.
Possible Risks and Complications:
While Endoscopic Lumbar Microdiscectomy is a relatively safe procedure, there are potential risks, including:
Infection at the incision site
Nerve injury (which could cause weakness, numbness, or pain)
Bleeding
Continued or new back pain
Injury to the disc or surrounding structures (such as blood vessels, muscles, or nerves)
Reherniation of the disc (although this is rare)
It is important to discuss these risks with your surgeon and follow all post-surgery care instructions to minimize the likelihood of complications.
Follow-Up Appointments:
You will need follow-up appointments with your surgeon to monitor your recovery, check for signs of infection, and assess your progress. During these visits, your surgeon may take X-rays or other imaging studies to ensure proper healing.
When to Contact Your Doctor:
Call your surgeon immediately if you experience:
Increased pain, redness, swelling, or drainage from the incision
Fever, chills, or signs of infection
Numbness, tingling, or weakness in your legs or lower back
Difficulty walking, standing, or moving
Any other unusual or worsening symptoms
Recovery and Prognosis:
Recovery Time: Most patients experience significant pain relief within the first few weeks after surgery. The initial recovery period typically takes 1-2 weeks, and many patients are able to return to light activities within 2-4 weeks. Full recovery can take several months as the spine heals.
Long-Term Outcome: Many patients experience lasting relief from sciatica and back pain after Endoscopic Lumbar Microdiscectomy. While the procedure aims to alleviate symptoms, some patients may experience occasional mild discomfort or stiffness as they recover.
Activity Limitations: You will be advised to avoid high-impact activities, heavy lifting, and strenuous movements for a period of time while the area heals. Gradual resumption of normal activities will be based on your doctor’s recommendations.
Important Notes:
Follow Instructions: Adhering to post-surgery care instructions and activity restrictions is crucial to ensure proper healing and reduce the risk of complications.
Physical Therapy: Completing any prescribed physical therapy or exercises is an essential part of your recovery process and can help you regain strength, mobility, and flexibility.
Support: It may be helpful to have assistance from family or friends during the early stages of recovery, especially for activities such as getting in and out of bed or walking.