Our Summary

This research paper discusses the use of minimally invasive surgeries for lumbar disc herniation (LDH), a condition where a disc in the lower back becomes damaged and causes pain. Two such surgeries, microendoscopic discectomy (MED) and percutaneous endoscopic discectomy (PED), are explored in detail. These types of surgeries are typically done with an endoscope, which allows the surgeon to minimize damage to muscles and soft tissues, reduce postoperative pain, and improve overall patient satisfaction compared to traditional open surgeries. The researchers have found that MED and PED are safe and effective alternatives to more invasive surgeries for people suffering from LDH. These less invasive procedures can also shorten the patient’s hospital stay and reduce the time it takes for them to return to work. However, these surgeries are complex and require a skilled surgeon and support team. More research is needed to confirm the superiority of MED and PED over traditional methods.

FAQs

  1. What are microendoscopic discectomy (MED) and percutaneous endoscopic discectomy (PED)?
  2. How do MED and PED surgeries for lumbar disc herniation (LDH) differ from traditional open surgeries?
  3. What are the potential benefits of using MED and PED for LDH treatments over more invasive surgeries?

Doctor’s Tip

A doctor might tell a patient undergoing a discectomy to follow post-operative care instructions carefully, including avoiding heavy lifting and strenuous activities for a certain period of time to allow the affected area to heal properly. They may also advise the patient to participate in physical therapy to strengthen the muscles surrounding the spine and improve overall recovery. It is important for the patient to communicate any concerns or changes in symptoms to their doctor to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for discectomy are those who have not responded to non-surgical treatments such as physical therapy, medications, and injections. These patients may be experiencing severe pain, weakness, numbness, or tingling in the lower back, legs, or feet due to a herniated disc pressing on a nerve. Candidates for discectomy may also have difficulty walking or performing daily activities due to their symptoms.

It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are appropriate candidates for discectomy. Factors such as the location and size of the herniated disc, the severity of symptoms, overall health, and previous treatments will be taken into consideration when deciding if surgery is the best option.

Overall, patients who are recommended for discectomy are those who are experiencing significant pain and impairment in their daily lives due to lumbar disc herniation and have not found relief from conservative treatments. These patients may benefit from the minimally invasive techniques of MED and PED, which can provide effective pain relief and faster recovery compared to traditional open surgeries.

Timeline

  1. Patient experiences symptoms of lower back pain, leg pain, and numbness or tingling in the affected area due to a lumbar disc herniation.
  2. Patient undergoes diagnostic tests such as MRI or CT scans to confirm the diagnosis of a lumbar disc herniation.
  3. Patient undergoes conservative treatments such as physical therapy, medications, and steroid injections to manage symptoms.
  4. If conservative treatments fail to provide relief, the patient and their healthcare team discuss the option of surgery, including minimally invasive options such as microendoscopic discectomy (MED) or percutaneous endoscopic discectomy (PED).
  5. Patient undergoes preoperative testing and preparation for surgery, including discussion of risks and benefits with the surgeon.
  6. Patient undergoes the minimally invasive discectomy surgery, which involves the surgeon using an endoscope to remove the damaged disc material causing pain.
  7. After surgery, the patient may experience some pain and discomfort as they recover, but this is typically less severe than with traditional open surgeries.
  8. Patient is discharged from the hospital sooner than with traditional surgeries and begins a rehabilitation program to help them recover and return to daily activities.
  9. Over time, the patient experiences improvement in their symptoms, including reduced pain and increased mobility, leading to a better quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a discectomy procedure?
  2. How long is the recovery process after a discectomy surgery?
  3. What type of anesthesia will be used during the procedure?
  4. Will physical therapy be necessary after the surgery?
  5. What are the success rates of minimally invasive discectomy surgeries compared to traditional open surgeries?
  6. How experienced is the surgeon in performing minimally invasive discectomy procedures?
  7. What type of imaging tests will be used to guide the surgery?
  8. Will there be any restrictions on physical activity or lifting after the surgery?
  9. How long do the benefits of a discectomy surgery typically last?
  10. Are there any alternative treatment options for lumbar disc herniation that should be considered before opting for surgery?

Reference

Authors: Kanno H, Aizawa T, Hahimoto K, Itoi E. Journal: Int Orthop. 2019 Apr;43(4):917-922. doi: 10.1007/s00264-018-4256-5. Epub 2019 Jan 3. PMID: 30607499