Why is endoscopic discectomy performed?
Endoscopic discectomy is performed in men and women with herniated, extruded or degenerated discs that are causing significant symptoms, such as pain radiating into the legs and arms. When discs become herniated or extruded, they can press on nerves or cause inflammation and swelling that can crowd nerves, resulting in shooting pain, dull aching sensations, weakness or numbness in the arms or legs. In disc degeneration, injury, wear and tear, or other factors cause discs to lose volume over time, resulting in inflammation and localized instability, both of which can irritate or impinge on nerves. Patients who undergo endoscopic discectomy have already tried more conservative approaches such as physical therapy or anti-inflammatory medications for a prolonged period without achieving resolution of symptoms.
How is endoscopic discectomy performed?
Endoscopic discectomy is typically performed using sedation, which means patients avoid the potential complications associated with general anesthesia. During the procedure, a small incision is made above the damaged disc and a thin wire is inserted and advanced until it comes in contact with the spine. The wire is guided using a fluoroscope to ensure it reaches the target area. After the wire is in place, a thin, flexible tube called a trocar is inserted through the incision using the wire as a guide. Once the tube reaches the damaged disc, it can be used to introduce the endoscope as well as specially-designed surgical instruments so the disc can be removed. The fluoroscope provides additional guidance throughout the procedure.
After the disc is removed, the tube and instruments are also removed and the incision is closed. Unlike traditional “open” discectomy surgeries, endoscopic discectomy retracts, or moves aside, muscles rather than cutting through them, resulting in less tissue damage and facilitating faster recovery and rehabilitation. Not everyone is a good candidate for endoscopic surgery, and a comprehensive physical exam prior to surgery will help the doctor determine if it’s a good choice for you.
What is recovery like?
Most endoscopic discectomies are performed as outpatient surgeries, which means patients can return home the same day. Although numbness and tingling can take a few weeks to completely resolve, most patients experience significant relief in their pain symptoms soon after their procedure. Some activities, such as twisting, bending and lifting, will need to be avoided for a few weeks after the procedure to enable the area to heal properly. Patients with relatively sedentary jobs are usually able to return to work, at least part-time, within a couple of weeks. Most patients can resume their regular activities within about six weeks. Physical therapy may also be used during recovery to help strengthen the back muscles and increase mobility and flexibility throughout the back. A physical therapist can also provide guidance and advice about changes in work and lifestyle habits that can help you avoid disc injuries in the future.
Will insurance cover the procedure?
Many insurance companies offer coverage for endoscopic discectomies when certain criteria are met, such as a failure of more conservative treatments to achieve a beneficial effect. Coverage limits can vary, so it’s important to ask your insurance company about your coverage prior to your procedure.