Intralaminar Lumbar Endoscopic Discectomy

What is an intralaminar lumbar endoscopic discectomy?

Intralaminar lumbar endoscopic discectomy is performed through a small tube placed through a small skin incision in the lower back. The small tube allows the surgeon to place an endoscope through the tube and to use tools through the endoscope to remove disc (discectomy) or to free the nerve from compression. Endoscopic means that the surgeon performs the procedure through a channel in the endoscope, while watching with the endoscope camera.

How is a intralaminar lumbar endoscopic discectomy performed?

Intralaminar lumbar endoscopic discectomy is a minimally invasive procedure for the treatment of pain arising from a disc herniation compressing or irritating the nerves of the spine. To start the procedure, a tiny skin nick is made on the skin of the lower back. A small tube is placed through the skin and, using the endoscopic camera and x-ray guidance, the tube is advanced to a natural opening of the spine, the intralaminar space. This effaces normally covered by a ligament. A tiny opening is made in the ligament, allowing the tube and endoscopic camera to be carefully placed in the spinal canal. The spinal canal is the opening in the back of the spine which runs from top to bottom. All of the spine nerves travel to the canal. Using the endoscopic camera for guidance, we nerves are carefully moved to side to expose the injured disc. The injured portion of the disc is then carefully removed.

What are the advantages of intralaminar lumbar endoscopic discectomy?

This procedure allows the identical type of surgery as a traditional discectomy but to a much smaller opening. The tube used for this surgery is 8 mm, as opposed to over 20 mm in a traditional microdiscectomy. The use of a smaller tube means a incision and a smaller opening into the spinal canal. The smaller opening results in less damage to healthy tissues and an easier recovery.

How long will the procedure take?

The procedure typically takes an hour to an hour and a half, depending on how many levels are operated on. After the procedure you will recover for two to four hours before going home.

What is the recovery like?

You will walk out the door and go home the same day with pain medications. For the first two to three days we advise plenty of rest with light stretching exercises. Activity should be tolerably increased over 7 days and should consist of short walks at first and a gradual return to normal daily activities. Avoid strenuous activity and heavy lifting (over 10 to 15 pounds) for the first several months. If one’s job is sedentary then work can be resumed in 7 days. At 4 weeks physical therapy can be resumed. Since the procedure is minimally invasive rehabilitation will generally be easier and faster than with traditional surgery. Recovery time will vary based on individual factors.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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