Endoscopic discectomy

Endoscopic discectomy is a form of minimally invasive surgery to remove a herniated disc.

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Orthopaedics

020 3214 3424

020 3214 3424

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What is an endoscopic discectomy?

An endoscopic discectomy is a surgical treatment to treat leg pain caused by lumbar disc herniations, which is done by removing herniated disc material to relieve pressure on the nerve root.

It is performed on patients with lumbar disc herniations with ongoing leg pain or who develop neurological symptoms despite conservative management.

Endoscopic discectomy is a form of minimally invasive surgery to remove the herniated disc which has been shown to reduce length of hospital stay and improve symptoms. It is an alternative surgical technique to conventional open microdiscectomy.

 

How do we do it?

  • The surgery is done as a day case under sedation and takes around 60 minutes.
  • You are usually positioned on your side and given pain relief, local anaesthetic and a sedative.
  • An X-ray is used to introduce a needle to the affected level of the spine.
  • A small cut is made in the scan and the endoscope which is a type of camera is inserted.
  • As you are not fully sedated you are able to give us feedback to ensure the endoscope is in the right location.
  • The disc is removed using the endoscope through the neural foramen (where the nerve leaves the spine).
  • We check to ensure the nerve has been decompressed and a small amount of local anaesthetic and steroid is given.
  • The small cut is closed with a dissolving stitch.

What are the risks?

Due to the minimally invasive nature of the procedure the risk of infection is <1%.

Similarly, there is a small risk of bleeding which typically does not cause any significant issues.

Rarely the lining around the spinal nerves can be torn and this can result in a fluid leak. Usually this does not require further surgery but may result in headaches that are worse when upright which normally resolve after a couple of days.

A new disc fragment can recur resulting in repeat symptoms. If you were to develop new nerve pain after the procedure we would request a new scan and discuss the next steps.

Despite the discectomy the leg pain can persist in up to 20% of people, this may be due to long term damage to the nerve caused the disc herniation.

Rarely it is not possible to remove the disc herniation through the minimally invasive approach and we need to convert to the open microdiscectomy procedure.

This would require you to be put under general anaesthetic.

There is a small chance of injuring the nerve during the procedure. The risk of persistent neurological injury is <1% but could result in weakness, sensory loss or
bladder, bowel or sexual dysfunction.

What is the post-operative care?

  • The procedure is done as a day case and most patients will be discharged home the same day. As you have been given sedation we would advise you are collected by a friend or family members.
  • There are no sutures to remove.
  • We will normally provide a soft brace prior to discharge to remind you not to overexert yourself.
  • We advise avoiding heavy lifting for three months and prolonged sitting and standing for the first six weeks post-operatively.
  • You will have a telephone follow up appointment at around six weeks and be discharged from routine follow up at that point if there are no issues.
  • There are no DVLA driving restrictions as long as you are able to safely undertake an emergency stop and check your blind spot.
  • If you develop any redness or leak from the wound, recurrent leg pain or swelling in the lower limbs after your procedure you can contact the spinal nurses or discuss with your GP.
  • After three months of no heavy lifting we would advise a gentle return to normal activity, you can avoid recurrent issues with your back by gentle exercise, stopping smoking and having a healthy and balanced lifestyle.
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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.