What is a Endoscopic Transforaminal Lumbar Disectomy?
Percutaneous means surgery is performed through a needle puncture, instead of a large skin incision. The use of a needle allows the surgeon to access the disc through a tiny opening in the skin and through natural openings in the spine. Once the needle is in place it is exchanged for a small tube that allows an endoscope to pass through it. Endoscopic means that the surgeon performs the procedure through a channel in the endoscope, while watching with the endoscope camera.
How is a percutaneous endoscopic lumbar discectomy performed?
Endoscopic Transforaminal Lumbar Disectomy is a minimally invasive procedure for the treatment of lower back pain due to a herniated disk. The patient is face down or lies on their side. A tiny skin nick is made on the skin of the back, near the flank. A needle is then placed through the skin nick and into the disc. A small wire is then placed into the disc, through the needle. The needle is exchanged for a series of small tubes. Using specialized instruments surgery is performed through these tubes. The procedure is guided by an endoscope, placed through the tube, and X-rays.
What are the advantages of Endoscopic Transforaminal Lumbar Disectomy?
Because a needle is used to access the disc from the skin a skin incision is not made, only a skin nick. Since the needle arrives to the disc via natural spinal openings healthy tissues are not disrupted. Unlike traditional minimally invasive surgery, muscles are not stripped from bone to access the spine, healthy bone is not removed to access the spinal openings and important spinal ligaments are not cut to access the disc. Performing surgery through a tiny skin nick and leaving healthy tissues intact means a same day procedure with a quicker recovery.
How long will the procedure take?
The procedure typically takes an hour to an hour and a half, depending on how many levels are operated on. After the procedure you will recover for about two hours before going home.
What is the recovery like?
You will walk out the door and go home the same day with pain medications. For the first two to three days we advise plenty of rest with light stretching. Activity should be tolerably increased over 7 days and should consist of short walks at first and a gradual return to normal daily activities. Avoid strenuous activity, heavy lifting (over 10 to 15 pounds) and twisting for the first several months. If your job is sedentary then work can be resumed in 7 days. At 4 weeks physical therapy or chiropractic care can be resumed. Since the procedure is minimally invasive rehabilitation will generally be easier and faster than with traditional surgery. Recovery time will vary based on individual factors.
Is a laser used to perform surgery?
The instruments used in endoscopic surgery are state of the art. Traditional surgical instruments have been miniaturized and elongated to fit through the endoscope. Specialized thermal probes are used to ablate diseased tissue through endoscope guidance. In some cases a laser is used to remove bone and disc.Despite the popularity of lasers in medical advertising, it’s important to realize that the laser is simply a tool in the surgeon’s arsenal, and not the surgery itself.
