Our Summary

This research paper discusses a new technique for performing a specific type of back surgery, called endoscopic transforaminal lumbar discectomy (ETALD). With advancements in technology, this method is becoming more popular among surgeons. The procedure uses a variety of specialized tools including a long endoscope (a type of camera), various types of surgical punches, a device that uses radio waves to cut tissue, and a device for irrigating and suctioning the surgical area.

During the surgery, surgeons must identify important parts of the spine including the tailbone, specific ligaments, and nerve roots. The paper suggests that the steps of the procedure are straightforward, especially if the surgeon is familiar with the tools and understands the anatomy of the spine well.

Research has shown that this procedure is as effective as traditional open microdiscectomy techniques. This new approach is seen as a safe option for this type of surgery, as it causes less tissue damage, results in lower post-operative pain, and allows patients to move around sooner after surgery.

FAQs

  1. What is endoscopic transforaminal lumbar discectomy (ETALD)?
  2. What are the benefits of endoscopic transforaminal lumbar discectomy compared to traditional open microdiscectomy techniques?
  3. What types of specialized tools are used in an endoscopic transforaminal lumbar discectomy?

Doctor’s Tip

One helpful tip a doctor might give a patient about discectomy is to carefully follow post-operative instructions, including proper wound care, activity restrictions, and physical therapy exercises. It is important to follow these guidelines to ensure a successful recovery and avoid any complications.

Suitable For

Patients who are typically recommended for discectomy procedures like ETALD are those who have herniated discs in the lumbar region of the spine. These patients may experience symptoms such as severe back pain, leg pain, numbness, weakness, or tingling in the legs.

Candidates for discectomy surgery are often those who have not found relief from conservative treatments such as physical therapy, medications, or injections. They may have tried these methods for a significant amount of time without improvement in their symptoms.

Additionally, patients who have significant nerve compression or impingement due to a herniated disc may be good candidates for discectomy surgery. This compression can lead to symptoms such as sciatica, which can be debilitating and affect a person’s quality of life.

Overall, patients who are in good overall health, do not have underlying medical conditions that would make surgery risky, and have exhausted conservative treatment options may be recommended for discectomy surgery such as ETALD. It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if this type of surgery is the best course of action for them.

Timeline

Before the discectomy procedure:

  • Patient experiences back pain, leg pain, and/or numbness due to a herniated disc pressing on a nerve in the spine
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm the diagnosis
  • Patient may try conservative treatments such as physical therapy, medications, or injections to manage symptoms
  • Surgeon recommends discectomy if conservative treatments are not effective

After the discectomy procedure:

  • Patient undergoes pre-operative evaluation and preparation for surgery
  • Patient is placed under anesthesia during the surgery
  • Surgeon performs the discectomy, removing the herniated portion of the disc that is causing symptoms
  • Patient is monitored closely post-operatively for any complications
  • Patient may require physical therapy or rehabilitation to regain strength and mobility in the affected area
  • Patient experiences relief from symptoms and improved quality of life post-surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with ETALD compared to traditional open microdiscectomy?
  2. How long is the recovery time for ETALD, and what activities should I avoid during the recovery period?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What type of anesthesia will be used during the procedure, and how long will I be under anesthesia?
  5. How experienced is the surgeon in performing ETALD, and what is their success rate with this procedure?
  6. Will I need any additional imaging tests or consultations before the surgery?
  7. What are the expected outcomes of the surgery in terms of pain relief and improvement in mobility?
  8. Are there any alternative treatment options to consider before undergoing ETALD?
  9. How long will I need to stay in the hospital after the surgery, and what will the post-operative care plan look like?
  10. What steps can I take to optimize my recovery and prevent any complications after the surgery?

Reference

Authors: Gulsever CI, Sahin D, Ortahisar E, Erguven M, Sabanci PA, Aras Y. Journal: J Vis Exp. 2023 Sep 8;(199). doi: 10.3791/65508. PMID: 37747222