Our Summary

This study looks at a less invasive procedure for treating herniated lumbar discs, commonly known as slipped discs in the lower back. The treatment, called endoscopic lumbar discectomy (ELD), can be done through two different approaches - the transforaminal (TF) and the interlaminar (IL).

The study found that both methods significantly reduced the disability and pain of the patients treated. However, the research also noted that the IL approach could be a better option for treating certain disc herniations that the TF approach might not be able to reach.

In simpler terms, the study suggests that both methods of this less invasive treatment for slipped discs are effective, but the IL approach could be more suitable for certain cases. This is good news as it provides an alternative to open surgical procedures, which can be more risky and require longer recovery times.

FAQs

  1. What is endoscopic lumbar discectomy (ELD)?
  2. What are the differences between the transforaminal (TF) and interlaminar (IL) approaches in ELD?
  3. According to the study, which approach between TF and IL is more suitable for certain cases of herniated lumbar discs?

Doctor’s Tip

A doctor might advise a patient undergoing discectomy to follow their post-operative care instructions closely, including proper wound care, physical therapy exercises, and restrictions on certain activities to ensure a successful recovery. It is important to listen to your body, gradually increase activity levels, and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help improve overall spinal health and reduce the risk of future disc issues.

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, and continue to experience severe pain, weakness, and numbness in the lower back, buttocks, and legs. These patients may have a herniated lumbar disc causing compression on the spinal nerves, leading to symptoms such as sciatica. Discectomy may be recommended for patients with a single-level disc herniation that is causing significant symptoms and affecting their quality of life. The less invasive endoscopic lumbar discectomy procedure may be considered for these patients as it offers a quicker recovery time and less risk compared to traditional open surgery.

Timeline

Before the discectomy procedure:

  • Patient experiences symptoms of a herniated lumbar disc, such as lower back pain, leg pain, numbness, or weakness.
  • Patient undergoes diagnostic tests, such as MRI or CT scans, to confirm the diagnosis of a herniated disc.
  • Patient discusses treatment options with their healthcare provider, including non-surgical options like physical therapy or medications.
  • If non-surgical treatments do not provide relief, patient and healthcare provider decide to proceed with a discectomy procedure.

After the discectomy procedure:

  • Patient undergoes the ELD procedure, either through the TF or IL approach, under general anesthesia.
  • The surgeon uses an endoscope to remove the herniated portion of the disc, relieving pressure on the nerves and reducing symptoms.
  • Patient may experience some pain and discomfort immediately after the procedure, which can be managed with medication.
  • Patient is typically able to go home the same day or the next day after the procedure.
  • Patient follows a rehabilitation plan, which may include physical therapy, to help strengthen the back and improve mobility.
  • Patient gradually experiences a reduction in pain and improvement in function over the following weeks and months.
  • Patient follows up with their healthcare provider for monitoring and to assess the effectiveness of the procedure.

What to Ask Your Doctor

  1. Can you explain the differences between transforaminal and interlaminar approaches for endoscopic lumbar discectomy (ELD)?

  2. How do you determine which approach is more suitable for my specific case?

  3. What are the potential risks and complications associated with ELD?

  4. What is the success rate of ELD in treating herniated lumbar discs?

  5. What is the expected recovery time after undergoing ELD?

  6. Will I need physical therapy or rehabilitation after the procedure?

  7. Are there any restrictions or limitations I should be aware of post-surgery?

  8. How long do the results of ELD typically last?

  9. Are there any alternative treatment options I should consider before proceeding with ELD?

  10. What is the likelihood of needing additional procedures in the future after undergoing ELD?

Reference

Authors: Mlaka J, Rapcan R, Burianek M, Rapcanova S, Gajdos M, Kocanova M, Griger M, Kovalicova L, Vaskova J, Kocan L. Journal: Bratisl Lek Listy. 2020;121(3):199-205. doi: 10.4149/BLL_2020_030. PMID: 32115977