Minimally Invasive Discectomy
Introduction
Minimally invasive discectomy is a relatively new option for those that need to undergo a discectomy to relieve pain associated with a prolapsed intervertebral disc. The recovery time from a traditional discectomy can take six weeks or more, while those that undergo minimally invasive procedures such as an endoscopic discectomy can recover in much less time.
Who Needs a Discectomy?
A discectomy is performed to correct a prolapsed intervertebral disc, or what is more commonly called a slipped disc. The intervertebral discs are made up of tough, fibrous connective tissues that protect a soft, gel-like centre. These discs are found between each of the vertebrae and act as cushions or shock absorbers. There are a number of reasons why these discs can become damaged. For younger adults, the discs are more often damaged because of an injury, such as lifting something too heavy. The protective outer fibres can tear, allowing the soft centre to bulge through the fibres. In older adults, a slipped disc can be the result of normal wear and tear. As we age, the outer fibres of the disc can weaken, allowing the soft centre to bulge through.
If the bulging centre of the disc puts pressure on nearby nerves, they can send pain to the nerve’s destination. This can happen to any disc along the spine, but most commonly occurs in the lower back, where pressure can be put on the largest nerve of the body that controls the legs: the sciatic nerve. The result is sciatica. This can include pain in the lower back as well as down the legs.
For most people, the disc will sort itself out with rest and anti-inflammatory medication. Some people may need to undergo a lumbar epidural, which sends pain killers and anti-inflammatory drugs through an injection to the damaged disc. Those patients that do not find relief through these less invasive treatments may need to undergo a discectomy, in which part of the disc that is putting pressure on nearby nerves is cut away in order to relieve the pressure.
Traditional Discectomy vs. Endoscopic Discectomy
The main differences between a traditional and endoscopic discectomy are the size of the incision that needs to be made and how the surgeon negotiates the surrounding muscles in order to reach the affected disc. The incision for a traditional discectomy is quite impressive, as the surgeon must be able to see where he is working without the aid of additional equipment. Also, the muscles must be stripped away from the spinal column in order to be able to accurately see the affected disc.
With an endoscopic discectomy, the incision only around two centimetres wide and the surgeon negotiates the muscles of the back through a tiny camera in the endoscope. Instead of stripping the muscles away, the endoscope creates a small tunnel through the muscles, which recovers much quicker. The tools needed to cut away the parts of the disc are miniscule and sent through the endoscope.
