What is Micro Endoscopic Discectomy (MED)?
Discectomy involves making use of a minimally invasive tubular retractor to remove a herniated disc that’s compressing a nerve root resulting in back and leg pain. Patients with persistent numbness, leg pain, tingling, or weakness not relieved by non-operative treatment usually undergo surgery. In this procedure, a tubular retractor is used to remove the herniated disc fragment and compression lesions. It is an outpatient procedure. It is common for patients to experience immediate pain relief, resume work within 5-10 days, and return to the same level of activity they had before the injury.
How does the process work?
Microdiscectomy relieves pain from a herniated disc by removing the material causing pressure on the spinal nerve root. During a microdiscectomy, a small incision is made in the middle of the low back. The first step is to lift the back muscles, called erector spinae, away from the spine’s bony arch. It is possible to move these vertically running muscles instead of cutting them. After removing a membrane covering the nerve roots, the surgeon can enter the spine. Ligamentum flavum is the name of this membrane.
Often, a portion of the inside facet joint is removed as a means of gaining access to the nerve root and reducing pressure on the nerve. Afterward, the disc material under the nerve root is gently removed from beneath the nerve root.
In order to preserve the healthy portion of the disc, only the herniated portion of the disc is removed. Once the irritating or inflamed portion of the disc is removed, the nerve is immediately relieved and can heal. Herniated discs can cause severe leg pain when they press on a nerve root. Nerve root healing may take several months, and there may be temporary weakness or numbness, but many patients experience relief from leg pain after microdiscectomy almost immediately.
What is involved in MED?
Micro Endoscopic discectomy requires general anesthesia and is performed as an outpatient procedure. An endoscopic approach using a tubular retractor entails a small incision (20 mm) and usually takes 45-60 minutes. The surgeon will remove a small portion of bone and ligament to expose the herniated disc and nerve root. A microscope or magnification loupes are used to examine the nerves and remove any disc fragments or adhesions. Most patients are discharged home the same day, returning to work within five to ten days and returning to normal activities after eight to twelve weeks.
Minimally Invasive Microdiscectomy
Outpatient lumbar discectomy options include microdiscectomy and
endoscopic discectomy. However, microdiscectomy remains the gold standard for removing the herniated disc portion pressing on a nerve. The reason is that it has a long history and many spine surgeons are familiar with it. Microdiscectomy technically involves open surgery, but is performed using minimally invasive techniques so little tissue is damaged during the procedure. However, however, some surgeons are now proficient in minimally and endoscopic or invasive procedures, which involve making an incision via a tube rather than an open incision. A neurosurgeon or an orthopedic surgeon typically performs a microdiscectomy.
Who is the ideal candidate for MED?
Candidates with “radicular” leg pain (sciatica), a straight leg on MRI, and a corresponding herniated disc are ideal for MED. In most cases, non-operative treatment for herniated discs can relieves leg and back pain within six to twelve weeks. However, some individuals (10-20%) may still experience persistent pain or suffer from severe diseases requiring surgical intervention. Surgical treatment is a personal decision based on objective medical science and carefully analyzed based on an individual’s benefit and risk profile. Spine surgeons who are fellowship-trained assess your eligibility based on a physical examination, your medical history, and imaging analyses (X-rays and MRIs).
What are the pros and cons of MED?
Micro Endoscopic discectomy has a high success rate if performed on properly selected patients. About 90-95% of patients will be better within a few weeks and many will be able to resume their pre-injury activities. The risks of surgery include but are not limited to:
-Dural tear (causing clear spinal fluid to leak),
-Recurrent disc herniation, and
-Chronic leg or back pain, weakness, tingling, or numbness
Additionally, undergoing general anesthesia can have medical risks, making preoperative evaluations necessary.
If you are experiencing chronic in leg or back pain in Richardson TX, schedule an appointment today.
POSMC – Plano Orthopedic & Sports Medicine Center
5228 W. Plano Pkwy,
Plano Texas 75093