A percutaneous endoscopic discectomy is a surgical option for treating a herniated disk in the spine. Doctors consider the procedure when conservative treatments are insufficient at relieving symptoms. Percutaneous endoscopic discectomy requires only a small incision to be made in the back, through which the orthopedic surgeon manipulates a camera, shearing tools, and a laser to correct the herniation. The outpatient procedure has a high success rate, and most patients experience near full recoveries within a few months.
When a vertebra-supporting disc in the spine becomes dislodged, it can cause chronic pain, muscle spasms, and potentially lead to spinal cord damage. Acute injuries and age-related degenerative disorders leave discs susceptible to herniation. Doctors usually try to manage symptoms of disc herniation with medications and physical therapy. A percutaneous endoscopic discectomy is performed when symptoms persist despite other treatment measures.
Percutaneous endoscopic discectomy is a relatively recent innovation in spine surgery, and it has grown in popularity since the 1990s. Compared to the invasive surgeries used in the past, the procedure is considered safe with a very low risk of possible complications. It can usually be performed in an outpatient spine center or hospital in less than an hour.
Depending on the location of the bulging disc, a patient may temporarily be placed under general anesthesia or simply given an injection of local anesthetic. Once the area is numb, the surgeon makes a small incision in the back and inserts a tube called an endoscope, a long tube with a light and fiber optic camera attached. The endoscope produces a video feed on a monitor, allowing the surgeon to thoroughly inspect the affected area.
Once the surgeon knows exactly what needs to be done, he or she inserts precision shears, a grinding tool, and a suction device into the incision. With the aid of the endoscope, tiny sections of bone and disc tissue are cut away and suctioned out of the spine. The surgeon is very careful not to damage nerve and muscle tissue in the region. In order to complete the procedure, a laser is used to strip away remaining layers of bulging disc tissue. Surgical tools are removed and the incision is cleaned and stitched.
Following a percutaneous endoscopic discectomy, a patient is brought to a postoperative recovery room so nurses can make sure that he or she feels normal. In most cases, the majority of pain and weakness symptoms associated with a bulging disc are resolved within a few minutes of the procedure. A full recovery can take several weeks or months, however, and a patient needs to attend follow-up visits with his or her spine doctor to make sure the discectomy was a success.