Spine Endoscopy: Endoscopic Discectomy For Slipped Disc And Sciatica

By Author: Dr. Pankaj Surange
Total Articles: 10
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Since we don’t have to cut the muscles and bones to open the entire spine, spine endoscopy has shown to be a boon for patients with spine problems. With the advancement in technology using 3 Chip camera and 4K monitors, now we can see each and every structure inside with more clarity and thus can avoid injury to important structures. At IPSC, we have best of the equipment’s for your safety and efficacy of the procedure.

Frequently asked questions
Q. Do all disc problems need spine endoscopy?
A. No! Spine endoscopy or Endoscopic discectomy is required for cases of slipped disc or disc bulge where your protruded disc is compressing the nerves. When the disc compresses the nerve, your pain will start going down to your legs which is called radiculopathy or sciatica.

Q. For how long we can avoid this procedure?
A. Usually we advise conservative treatment in the form of medications, physiotherapy in selected cases and some exercises after examining the patient. If the condition is not urgent, we usually wait for 2-4 weeks. But, in cases where the disc herniation is large and compressing the nerves, ...
... it is advised to get it removed as soon as possible. Compression of the nerves for longer duration, may lead to irreversible damage to the nerve. In these cases, patient may develop foot drop or muscle weakness or some neurological deficit.

Q. If I already have some numbness or weakness in the lower limb, can we still go for endoscopic discectomy?
A. If there is a major loss of function like loss of bladder and bowel control, loss of limb movements, sense less leg, in such cases we do open surgical discectomy.
In patients with some numbness or tingling, we can safely go for endoscopic discectomy.

Q. Do you remove the complete disc from that level
A. No. We only remove the protruded part of the disc. By selectively removing that bulging part, we relieve the nerve off the pressure.

Q. Is there any chance of re herniation of disc?
A. Although rare, but it is possible if we don't take proper precautions after endoscopic discectomy. We usually advise 4 weeks of lumbar support belt after the procedure, along with some restriction of activities like prolonged sitting, forward bending, and weight lifting.

Q. Do u cut the bones and muscles to reach the disc?
A. No. That is not required in the endoscopic procedure. Infact, we preserve even the normal disc which is close to protruded disc. This prevents the collapse of the disc in future.

Q. Can this procedure be done under local anesthesia?
A. Yes. We make a small hole on the skin under local anesthesia and infiltrate the entire track up to the disc with local anesthesia. Patients are awake throughout the procedure and this adds safety to the procedure as we can detect any touching to the nerve while removing the disc.

Q. What are the complications
A. Complications are possible but rare with this technique as compared to open surgery. The possibility of nerve injury, bleeding, and infection at the site are there and in most cases are manageable.

Q. Is endoscopic discectomy covered under medical insurance?
A. Yes, it is covered but one day admission is required for insurance purpose. At IPSC, for non-insurance patients we do this procedure as a day care and we discharge them after 4-6 hours of observation.

Dr (Maj) Pankaj N Surange MD, FIPP, FIAPM
Director, IPSC India
Hon Secretary, Indian Society for the study of Pain, National