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Endoscopy for Lumbar Disc Herniation

ENDOSCOPY FOR LUMBAR DISC HERNIATION

Disc herniation occurs over time due to degenerative changes (wear) of the intervertebral disc, which can lose its flexibility, elasticity, and shock absorption characteristics. The hard fibrous wall of the disc may then weaken and split and no longer be able to contain the gelatinous substance in the center.

This material can bulge or protrude through a tear in the wall of the disc (herniation), causing pain when it compresses the nerve root (sciatica). A nerve is like an electrical cable. It tells your muscles to move and gives your brain information about various sensations such as pain, temperature, light touch, pressure sensation, and the position of your legs.

Lumbar nerve root pain (sciatica) usually goes below the knee and is felt in the area of the leg that innervates the particular spinal nerve. Symptoms also associated with sciatica include altered sensation, tingling, burning, numbness or even weakness of the leg muscles that the nerve supplies.

The definitive diagnosis of herniated disc is usually made by MRI.

VIDEOS OF ENDOSCOPY FOR LUMBAR DISC HERNIATION

Herniated disc surgery is perhaps the most grateful spine surgery. Radiating radicular pain (sciatica) disappears immediately. It can be performed through conventional open surgery, mini-open surgery with a microscope or through endoscopic surgery (mono or biportal). The technique chosen will depend on the type and location of the pathology.
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WHAT CAN I EXPECT AFTER ENDOSCOPIC HERNIATED DISC SURGERY?

It is very normal to experience some level of discomfort or pain in your back and legs in the immediate postoperative period. The medical and nursing staff will help you manage it with the appropriate medication. The symptoms of pain in the leg will no longer exist, although there may be some residual discomfort that may be relieved spontaneously in a few days.

The staff physiotherapist will visit you after the operation to teach you exercises and help you get out of bed. They will show you the correct way to move safely. Once you are confident and able to move independently, you will be encouraged to practice going up and down stairs. Once stable, you will be allowed to return home, sometimes the same day, but usually the day after surgery.

Wound Care

The wound is 1-2 centimeters and a single closure stitch is placed with 3-0 Prolene thread.

The definitive closure of the wound will be 10-14 days after surgery and you will be scheduled for removal of the stitches and medical review.

You can shower 48 hours after surgery if you are careful, but you should avoid getting the bandage too wet. Most dressings used are "waterproof", but if water gets underneath, they will need to be changed to keep the wound dry. It is enough to use a simple, dry pharmacy dressing. Immersion baths should be avoided for two weeks.

When can I start driving?

You will typically be advised to avoid driving for 2 to 4 weeks, depending on the type of surgery you have had. If you do not have any altered sensations or weakness in your legs, you can return to driving if you feel safe, but you must be confident to make an emergency stop. It is advisable not to travel long distances initially (no more than 20 minutes), without taking a break to “stretch your legs.” Gradually increase your tolerance to sitting over 4 to 6 weeks.

Recreational activities and sports

It is important to stay mobile after surgery. You will notice that you get stiff if you sit for more than 20 minutes, so get up and walk regularly. Walking outside is fine, but again, gradually increase the distance you walk. The fibrous wall of the disc cannot be repaired during surgery and will heal at different times for each person, so you will be advised to avoid heavy lifting, certainly for the first 2 to 3 weeks after your operation. Then a gradual return to sporting activity is advisable. As a matter of prudence, it is advised to avoid doing weight-bearing sports or flexion of the trunk during the first month, although many of our patients feel confident and without symptoms and develop gradual sports activity starting 15 days after the intervention.

Return to work activity

Returning to work depends on both your recovery and your employment. Most people are off work for the first two weeks, but if you have a strenuous or physically demanding job you may need up to six weeks. It is always sensible to talk to your employer about whether you can return on “light duty” or reduced hours initially. Generally, there is nothing stopping you from working in office activities, as long as you can continue to move regularly.

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