Selective Endoscopic Discectomy

Endoscopic discectomy is a minimally invasive spine surgery performed to treat disc problems that cause back and leg pain. A unique feature of this technique is the technology used to access the spine; through a keyhole incision, surgery is performed using an endoscope.

An endoscope is a flexible or stiff tube with a tiny camera at the end. The endoscope delivers the surgeon an excellent view of the disc and related structures. The enhanced view allows the surgeon to select the part of the disc to be removed. Instead of cutting through tissues (e.g., muscle) to access the spine, dilation tubes gently separate soft tissue and are graduated in size to enlarge the operative field.

Some of the benefits of endoscopic discectomy include:

  • tiny incision
  • less tissue disruption
  • less blood loss
  • less post-operative pain
  • quicker recovery

Endoscopic discectomy is a generic term for Selective Endoscopic Discectomy™ (SED) and the Yeung Endoscopic Spine Surgery (YESS™) systems.

Degenerative disc disease (DDD), disc herniation, and disc bulge are examples of disc-related problems that may compress or pinch spinal nerves and cause low back, buttock and leg pain. Other neurologic symptoms may include numbness, tingling and weakness in one or both legs. The goal of endoscopic discectomy is to decompress the nerves, relieve symptoms, and enable the patient to quickly return to regular activities of daily living.

Not every patient with DDD or disc problem requires spine surgery. Dr. Stieber may recommend endoscopic discectomy for the following reasons: non-operative treatment fails to relieve symptoms, progressive worsening of neurologic symptoms or pain, and/or neurological problems. Numbness, loss of function, and weakness are examples of neurologic dysfunction.

About the Endoscopic Discectomy Procedure

Endoscopic discectomy is performed under local and/or epidural anesthesia; the patient is awake during the surgery. The back area is cleansed and prepared for surgery. A small needle is inserted into the disc, guided by fluoroscopy, a type of X-ray used during surgery. A tiny skin incision is made, and the dilation tube is slipped into place, followed by the endoscope.

Special miniature-sized instruments (eg, forceps, cutters) are advanced through the tube. A laser probe removes only the damaged disc part and binds the disc wall (anulus fibrosus). The laser also reduces (shrinks) the size of the disc to decompress nerve roots. The procedure takes about 30 minutes to one hour per disc. The incision is dressed with a small bandage.

After Surgery

After surgery, the patient is moved into the recovery area. In recovery, nurses and other members of the medical team closely monitor the patient’s vital signs – pulse, respiration, blood pressure, and pain. Some post-operative pain should be expected, and patients receive pain medication either through their IV (intravenous line) or by mouth. When the patient is alert and Dr. Stieber approves, the patient is discharged home the same day of surgery.

After Care at Home

Dr. Stieber provides spinal endoscopic discectomy patients with information about what to expect and self-care after hospital discharge. This information includes instructions to control pain, medications, diet, and managing constipation, bathing and wound care, activity restrictions, and the surgical follow-up appointments. As always, Dr. Stieber and his staff welcome questions and ensure that all patient concerns are thoroughly addressed.