What is endoscopic lumbar discectomy?
Endoscopic lumbar discectomy is the smallest and least traumatic procedure to remove
a portion of a herniated lumbar disc.
How is it done?
The surgeon makes a small incision at the back or side of the patient
and inserts
a Richard Wolf endoscope (invented by Dr Sebastian Ruetten) into the
patient's spinal canal. The surgeon then inserts other instruments through the endoscope
to remove a portion of the herniated disc. The operation is done under general anesthesia
and takes approximately 30 minutes. The patient is able to walk immediately after
the operation and is required to stay in the hospital for only 12 to 24 hours.
Why is it done?
It is done to remove a part of the patient's herniated disc which is putting pressure on the nerve roots, causing intractable pain or other severe problems. The procedure is considered when:
- The patient's back and leg pain does not subside after 6-12 weeks of anti-inflammatory
medications and/or epidural injections with bed rest and rehabilitation.
- A profound weakness is found in the patient's leg.
- The patient is unable to control his/her bladder or bowels.
Risks and complications
As with any surgery, there are risks, including the possibility of:
- Complications associated with anesthesia, including respiratory or cardiac malfunction.
Risk of infection is low because the operating field is irrigated with water throughout the operation.
- Paralysis; i.e., loss of use of the legs, loss of sensation and loss of control
of bladder and bowels (less than 1%).
- Temporary numbness or weakness recovered within three to four weeks (5%).
- Recurrent herniated disc can be expected in 10 to 15% of cases (compared to 10 to 30%
if operated using other procedures). This recurrence may require a repeat procedure.
Risks can be reduced by following the physician's instructions before and after
surgery.
Endoscopic lumbar discectomy at Bumrungrad
Our team is led by a neurosurgeon and orthopedic surgeon who were trained by the developer of this technique, Dr Sebastian Ruetten, in Germany. They have performed 30 procedures in Germany and more than 120 in Thailand, with 90% excellent or good results.
Candidate eligibility
The surgeons will make a final determination of each patient’s eligibility for the
procedure after an examination of the patient together with MRI and x-ray images.
Overseas patients may send their details with MRI and x-ray images for discussion
with the surgeons before visits.