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Is endoscopic discectomy effective for treatment of herniated disc?

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Posted on Wed, 15 Oct 2014
Question: Deat doctor
I have a herniated disc at my L5-S1 and i have to do surgery in order to cut of the herniated part. What is the best method ( e.g. Endoscopic Discectomy... ) for this surgery ? I mean the name of the surgery ? How long it takes to recover for the surgery? And just to let you know, i don't have any problem regarding money.
So please tell me the best method ?
doctor
Answered by Dr. Naveen Kumar Sharma (5 hours later)
Brief Answer:
Endoscopic Discectomy is best method

Detailed Answer:
Hello,
Lumbar disc can be removed by many methods. Endoscopic discectomy is best. In this method disc excision is done with the help of endoscope. It needs very small incision and you can start walking from next day. It can be done only when your disc is not much displaced. It is available at very few centers.
Other method is minimal invasive discectomy. In this incision is little bigger and recovery time is five to ten days. It is better procedure when disc is slightly displaced, because with a slight bigger incision decompression is better.
I would suggest you to let your surgeon choose one of the above mentioned method. Soon you will be relieved of pain.
I hope this answer will be helpful. Let me know if there is any other followup questions.
thanks
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naveen Kumar Sharma (21 minutes later)
Thank you so much for this detailed answer!
And also would you please tell me about the anesthesia? And how do i know if the disc is much not displaced ( myself )? I am asking this because of MAYBE the lack of equipment in my country IRAN , may make the surgeon to use other methods! So i am asking you if you can maybe show me some examples of MRI in which the endoscopic is ok and which is not ok with endoscopic?
doctor
Answered by Dr. Naveen Kumar Sharma (9 minutes later)
Brief Answer:
Please send me your fresh MRI

Detailed Answer:
Hello,
I would suggest you general anesthesia, but let your surgeon decide. Advantage of general anesthesia (Patient is unconscious) is that patient has no memory. And it is much safer.
Other method of anesthesia is spinal, in which patient is conscious. I would recommend general anesthesia.
In MRI report if it is mentioned that disc is migrated or sequestrated than it means disc is displaced.You can send me your MRI report and I can guide you what type of surgery is better for you.
Thanks
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naveen Kumar Sharma (1 hour later)
Ok i will send you the report in 1 day. Thanks
doctor
Answered by Dr. Naveen Kumar Sharma (3 minutes later)
Brief Answer:
I am waiting.

Detailed Answer:
Hello,
I am waiting for those reports.
Thanks
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
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Follow up: Dr. Naveen Kumar Sharma (2 days later)
Here i attached the MRI fotos.
doctor
Answered by Dr. Naveen Kumar Sharma (2 hours later)
Brief Answer:
You will need microdissectomy

Detailed Answer:
Hello,
I have studied your MRI report, and L5S1 disc is showing disc migration both Superior and inferior direction. So endocopy method is not possible.I would suggest you to get general anesthesia and Microdissectomy. Do not delay this surgery as it is looking quite advance. If it is not removed then complication can occur like nerve weakness or bladder bowel problem.
So try to get this procedure as soon as possible.
thanks

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Naveen Kumar Sharma (1 hour later)
Thanks for your concern and suggestions. I'll do the surgery tomorrow morning as i have discussed with my doctor . But he insisted in endoscopy! As you said microdiscectomy is more benficial , but since it'll need some laminotomy and the recovery from the surgery takes longer than endoscopy, i think i'll have no option other than endoscopy !
doctor
Answered by Dr. Naveen Kumar Sharma (1 hour later)
Brief Answer:
Endoscopy is also good

Detailed Answer:
Hello,
I wish you a fast recovery. If your doctor is feels confident that he can tackle this disc with endoscopic discectomy then you can go ahead with this. You are right that you will not need any laminotomy so recovery is faster.
Once again best of luck.It was pleasure talking to you.
thanks.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
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Dr. Naveen Kumar Sharma

Orthopaedic Surgeon, Joint Replacement

Practicing since :2002

Answered : 4486 Questions

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Is endoscopic discectomy effective for treatment of herniated disc?

Brief Answer: Endoscopic Discectomy is best method Detailed Answer: Hello, Lumbar disc can be removed by many methods. Endoscopic discectomy is best. In this method disc excision is done with the help of endoscope. It needs very small incision and you can start walking from next day. It can be done only when your disc is not much displaced. It is available at very few centers. Other method is minimal invasive discectomy. In this incision is little bigger and recovery time is five to ten days. It is better procedure when disc is slightly displaced, because with a slight bigger incision decompression is better. I would suggest you to let your surgeon choose one of the above mentioned method. Soon you will be relieved of pain. I hope this answer will be helpful. Let me know if there is any other followup questions. thanks