Endoscopic surgery for herniated discs

Herniated discs or discs are quite common and can severely incapacitate the patient, bringing with them chronic pain and decreased mobility.

However, and despite the fact that its only definitive treatment is surgery to repair the damage to the problematic intervertebral disc, new and better ways of approaching it surgically have emerged, with minimal consequences as with endoscopic surgery.

What is endoscopic surgery for herniated disc?

This minimally invasive technique is the best alternative to traditional herniated disc surgery, known as microdiscectomy, in which large incisions are required.

The main advantage of endoscopic surgery for the spine is that the manipulation of the delicate tissues of the back is reduced to the maximum and therefore, the pain after the surgery and the associated risks (such as bleeding or infections).

In this way, the patient with a herniated disc can feel confident that their problem will be solved quickly and only using local anesthesia, with which they can return home in a short time to continue recovery and, best of all, pain relief.

Why do herniated discs occur and in which cases is endoscopic surgery recommended?

Intervertebral discs are thick cartilage cushions that separate one vertebra from another, allowing mobility of the spine and cushioning pressure changes while walking, running or just sitting.

However, sometimes the tissue that makes up the annulus fibrosus (the peripheral part of each intervertebral disc) can degenerate and become fragile. If a sudden movement occurs, this ring breaks and exposes part of the pulposus content (the inner part of the disc), protruding towards the spinal cord or nerve roots.

This is what causes pain and can affect nerve function (mobility and sensation) and there is no other way to fix the injury than with surgery.

The endoscopic approach to disc surgery has shown excellent results in the following types of hernias:

Foramen disc herniation.

Peripheral disc herniation to the foramen (or extraforaminal, one of the most frequent).

Posterior or lateral disc herniation.

Not only in herniated discs this surgical technique has been useful but also in other spinal problems such as spinal canal stenosis, a pathology in which the duct through which the spinal cord runs narrows, causing compression, chronic pain, loss of sensitivity and joint mobility.

If the herniated disc is accompanied by calcified processes or spondylolisthesis (less frequent), the spine surgery should probably be open or conventional.

How is endoscopic surgery to treat herniated discs?

It is made with a couple of small incisions (5 to 8 mm) in the skin of the back, at the height of the problem. A small cannula with a camera at the end (to visualize the internal structures) and surgical instruments are inserted there.

Through them, the surgeon will assess the magnitude of the problem and repair the defect (that is, he will remove part of the tissue that is compressing the spinal cord and close the opening of the annulus fibrosus).

Upon completion, the surgeon closes the small incisions in the skin with sutures and the patient can continue to rest.

Advantages of endoscopic surgery compared to conventional surgery

As tissue manipulation is minimal, the advantages are greater and among them

Reduction of postoperative pain.

Lower risk of bleeding.

Lower risk of infections.

Short recovery time and quick incorporation to activities.

No use of general anesthesia.

No scars on the back.

Medical discharge can occur in the first 24 hours after surgery and full recovery can range from 6 to 12 weeks.

Other surgical techniques to treat herniated discs

It is important to understand that the endoscopic approach to treating herniated discs is just a more modern variant of the traditional and reliable nucleotomy technique, which we have in our medical center.

Nucleotomy differs from endoscopic surgery because it does not use video cannulas, however, the results can be very similar and with the advantage that it is still a minimally invasive technique to the tissues. It is just as safe and shows the same results as endoscopic surgery.

In addition to nucleotomy, we have a somewhat more conventional but useful, safe and updated technique. This is known as "removal or percutaneous surgery" to repair herniated discs in both the lumbar region (where they are most common) and the cervical region.

Percutaneous removal is a minimally invasive technique where open surgery is not necessary, like the previous ones, but with the advantage that it lasts very little (about 30 minutes or less) and the patient can return home the same day.

But why is the latter so special? Precisely because of the minimum invasiveness to the tissues together with maximum safety for the patient, coupled with its speed (not only to perform it but so that the patient perceives the improvement).

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