Overview
This minimally-invasive procedure is performed through a 7mm tubular device.
It is designer to relieve pain caused by herniated discs pressing on nerve roots. This surgery is performed under local anesthesia, allowing the patient to leave the hospital the same day.
Step 1
After the disc defect is stained with Evocative Chromo-discography TM and the disc protrusion is confirmed, a guide wire is inserted to the affected disc. The surgeon uses a special type of x-ray machine, called a fluoroscope to ensure that the route to the herniated disc is made in the correct location.
Step 2
A two-hole obturator tube passes over the guide wire to push apart the tissue down to the disc. It also moves the nerve root out of the way.
Painful tissue in the path of the obturator can be anesthetized with .5% lidocaine delivered with a spinal needle through the second hole.
Step 3
The working sleeve, through which the surgery will be performed, slides over the two-hole obturator. It is positioned on the disc surface, visualizing the annulus and epidural space. The guide wire and obturator are then removed.
Step 4
A surgical light and small camera are placed through the tube to view the annulus, disc, and epidural space on a video monitor. The rest of the procedure is viewed with this endoscope to guide the surgeon’s tools and inspect the results.
Step 5
Surgical instruments are used to enter the disc and remove degenerative and extruded portions of the disc nucleus. Because only enough of the disc is removed to reduce pressure inside the disc, the spine remains stable. Before the instruments and sleeve are removed, the disc wall defect is treated with a laser and radiofrequency probe.
Step 6
Before the instruments and sleeve are removed, the disc wall defect is treated with a laser and radiofrequency probe. Then, the foramen and nerves are inspected to confirm successful decompression
End of procedure
The insertion area in the skin is covered with a small bandage. Because no muscles or bone are cut during the procedure, recovery is fast. The patient may need a day of bed rest after the procedure and physical therapy. Most may return to normal activity within one to six weeks.