Our Summary

This study investigated whether a specific type of back surgery (transforaminal endoscopic discectomy) used to treat herniated discs could be done safely and effectively on patients who are awake and only under local anesthetic. The study involved 100 patients who were treated by the same surgeon. The patients’ pain levels were measured before and after surgery, and the amount of time they spent in recovery was also recorded.

The results showed that, on average, the patients’ pain levels significantly decreased after surgery, and they spent less than an hour in recovery before being sent home. The complication rates were similar to those reported in previous studies, with the most common issue being nerve pain, especially for patients with certain types of herniations. Importantly, no patients in this study needed to be put under general anesthetic or transferred to a hospital, and there were no permanent nerve injuries reported.

In conclusion, the study suggests that this type of back surgery can be done safely and effectively on awake patients, leading to quick recovery and significantly reduced pain.

FAQs

  1. Can transforaminal endoscopic discectomy be safely performed on awake patients?
  2. What were the most common complications encountered in the study on awake discectomy?
  3. How did the surgery affect the patients’ pain levels and recovery time?

Doctor’s Tip

A helpful tip a doctor might tell a patient about discectomy is to follow post-operative instructions carefully, including avoiding heavy lifting, bending, or twisting for a certain period of time to allow the spine to heal properly. It is also important to attend follow-up appointments and physical therapy sessions as recommended to ensure the best possible outcome and prevent future complications. Additionally, maintaining a healthy weight, practicing good posture, and engaging in regular exercise can help prevent further disc issues in the future.

Suitable For

Patients who are typically recommended for discectomy are those who have not responded to conservative treatments such as physical therapy, medications, and injections for herniated discs. Patients with severe and persistent back or leg pain, weakness, numbness, or tingling due to a herniated disc may benefit from discectomy surgery. Additionally, patients who have tried other non-surgical treatments for a significant amount of time and have not seen improvement may be good candidates for discectomy. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if discectomy is the right choice for them.

Timeline

Before the discectomy:

  • Patient experiences pain, numbness, or weakness in the back or legs
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm herniated disc
  • Patient consults with a surgeon to discuss treatment options, including the possibility of a discectomy
  • Patient prepares for surgery by following pre-operative instructions from medical team

After the discectomy:

  • Patient undergoes transforaminal endoscopic discectomy procedure while awake under local anesthetic
  • Patient experiences decreased pain levels immediately after surgery
  • Patient spends less than an hour in recovery before being discharged home
  • Patient may experience temporary nerve pain as a common complication
  • Patient does not require general anesthesia or hospital transfer
  • Patient does not report any permanent nerve injuries
  • Patient follows post-operative care instructions to aid in recovery and prevent further injury

What to Ask Your Doctor

  1. What is the success rate of transforaminal endoscopic discectomy in treating herniated discs?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery period after undergoing this surgery?
  4. Are there any specific guidelines or restrictions I should follow post-surgery?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How soon can I return to work or regular activities after the surgery?
  7. Are there any alternative treatments or procedures that I should consider before opting for discectomy?
  8. What type of anesthesia will be used during the surgery?
  9. How experienced is the surgeon in performing transforaminal endoscopic discectomy?
  10. What is the expected outcome in terms of pain relief and overall improvement in mobility after the surgery?

Reference

Authors: Alexander N, Gardocki R. Journal: Eur Spine J. 2023 Aug;32(8):2910-2917. doi: 10.1007/s00586-023-07786-2. Epub 2023 Jun 28. PMID: 37369749