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Neurosurgical and Spine Institute

Endoscopic Discectomy

The intervertebral disc is an elastic, soft cushion located in between the spine bones called vertebrae. The disc provides shock absorption when pressure is added to the spine.

Neurosurgical

When the disc is ruptured (herniated), the inside portion (nucleus) spills out and could cause the nerves to become pinched.(See Herniated DiscEnlarged view of image)There is normally a little extra space around the spinal cord and spinal nerves, but if enough of the disc is pushed out of place, then these structures may be compressed.

Disc herniation is could be a direct result of an accident, fall, or repetitive strain. Most common symptoms include: leg pain, muscle weakness, and tingling sensations in the abdominal region.

MRI scans (special x-ray) usually identify most cases of disc herniation. To alleviate pain caused by disc herniation, your Tower Orthopaedics specialist may suggest endoscopic surgery. Your doctor may relieve the nerve compression by removing the intervertebral disc (called a disectomy). Also pressure on the nerve can be relieved by trimming or removing the roof, or lamina, of the vertebra to create more space for the nerve (called laminectomy).

The Endoscopic discectomy procedure is performed under a local anesthesia. During this procedure a small, specially-designed, endoscopic probe is inserted through the skin of the back between the vertebrae and into the herniated disc space (See Device InsertNeurosurgical and Spine image). Tiny surgical attachments are the sent down the hollow center of the probe to remove a portion of the offending disc (See Tissue RemovalEndoscopic Fusion). The microsurgical attachments can also sometimes be used to push the bulging disc back into place and be used for the removal of disc fragments and small bony spurs.

 

Endoscopic Fusion

The spine is a very delicate part of the body and surgeons are performing many spinal surgeries everyday. Technology breakthroughs in surgical techniques have transformed the way spinal surgery is being performed. One popular procedure your Tower Orthopedics specialist may use is known as an endoscopic fusion. An endoscopic fusion is a minimally invasive procedure that involves the use of specialized surgical instruments to insert bone replacement material or implants replacing diseased intervertebral discs. The bone replacement is secured by specialized screws and rods to initialize the fusion process.

To further understand the concept of an endoscopic fusion, a small description of the spine’s anatomy is necessary. Some duties of the spine are to maintain your body’s structure, protect the nervous system, and absorb the pressure from movement. In order to fulfill its duties, the entire structure of the spine must be sound. The spine is separated into three main regions: The upper spine or cervical spine is the neck region; the thoracic spine is the middle back region; the lumbar is the lower region. The bones that make up the spine are called vertebrae(See Spine Anatomy 1Enlarged view of image).Between each vertebra are gel-like discs called intervertebral discs (See Spine Anatomy 2Enlarged view of image). Strong ligaments hold the vertebrae together like rubber bands. Muscles, joints and nerves run up and down the spine giving it flexibility and strength.

Excessive strain, trauma, or age may cause an intervertabral discs to rupture. A disc rupture (herniated disc) disrupts the natural hydraulic effect that the disc normally provides. Unable to support the weight of the body, the space between the vertebrae narrows as do the pathways that the nerves run through (foreman). This causes a pinching of the nerves usually producing pain in the back or legs. The joints that keep each vertebra in the spine from rubbing together are called facet joints. Over time, the facet joints may become arthritic and loose their cartilage which then causes vertebrae to slide on one another even adding more pressure to the nerves.

Tower Orthopaedics specialists can diagnose spinal conditions by using an MRI scan. An MRI scan is an imaging system where radio waves and strong magnetic fields provide detailed information about internal organs.

Pending diagnosis, an endoscopic spinal fusion may be an elected procedure by your surgeon. This goal of this procedure is to relieve pain and stabilize the spine. The procedure is usually performed under local anesthesia, followed by a small well positioned incision into the affected area. A magnified video system provides guidance for a small endoscopic probe that is inserted between the vertebrae and into the diseased disc (See EndoscopeEnlarged view of image).Small surgical instruments are sent through the probe to remove portions of the offending disc (discectomy) relieving pressure on the spinal nerve. Once the disc is removed, a bone graft or implant device may be inserted to commence the fusion process. Screws and a rod are placed between the altered disc securing the bone replacement (See ScrewsSee Spine Anatomy,and Endoscopic viewEnlarged view of image).The endoscope is then removed followed by stitching of the small incision.

Pain relief occurs instantly after surgery due to the released pressure on the spinal nerve; however, some movement may feel awkward until the bone heals and the fusion process is complete.