The advanced minimally invasive and endoscopic procedure is a combination of two top procedures, in which the hernia of the intervertebral disc and the epidural space are treated simultaneously. During the procedure, in contrast to conventional surgery, there is minimal damage to muscle and bone structures. The advantage of this technique is also a faster recovery, together with a faster return to active life and a significant saving of time that the patient would otherwise spend in two operations.
How does the procedure work?
· Under X-ray control, a special needle is inserted to the spine (usually laterally through the foramen intervertebrale) to create a working channel. The endoscope and tool set are then inserted. The inserted endoscope shows the extent to which the herniated disc is pushing on the nerve root. During continuous visualization, the herniated disc is then removed with special endoscopic instruments. The disc is finally treated with thermal radiofrequency, which closes up the back ring of the damaged disc in the posterior intervertebral disc segment. The aim is to reduce the risk of re-herniation and to remove the focus of the pain and pathological nerve structures around the disc.
· After removing the fragment of the intervertebral disc, we enter the anterior epidural space through a natural hole in the sacrum (hiatus sacralis) with a flexible endoscope (epiduroscope). The aim of this procedure is an optical visualization of the anterior epidural space in the area of the sacral and lumbar canal up to the height of the performed endoscopic discectomy. In case of the discovery of pathological changes in the epidural space, an immediate additional therapeutic intervention is possible (administration of anti-inflammatory drugs, disruption of adhesions, remnants of disc fragments).
- Procedure without hospitalization
- Performed under local and light anesthesia (analgesia)
- Duration of the procedure: from 40 to 90 minutes
What happens after the procedure
- After the procedure, the patient stays in a special resting room for about 120 minutes to rest and then can return home accompanied by another person.
- After the procedure, the patient will receive a medical report, where we recommend a 4-6 weeks sick-leave (issued by a general practitioner).
- It is not possible to drive a car in person after the performance – it is necessary to ensure the patient has someone else to drive them, ideally for the patient to be in the passenger seat with the seat folded back.
- For the first 1-2 days it is recommended to stay in bed, with limited sitting and standing, and during the first week a rest-regime.
- From the 7th day after the operation, the patient enters the postoperative mode with movement recommendations, exercise and physiotherapy.
- Return to normal activities and work is very individual. It depends on the patient’s health condition, the process of soft tissue healing, type of employment, etc. This is usually 4 to 6 weeks after the procedure.
- We will contact you by phone in 24 hours and 14 days after the procedure.
How recovery takes place
The goal of treatment is to achieve relief from back pain by removing or reducing its intensity and thus improve the patient’s quality of life. During recovery, it is necessary to actively participate in the programme of postoperative and physical measures, which will help you recover faster and return to normal life. Your doctor will instruct you in detail about these measures immediately after the procedure. A “hotline” is available for patients immediately after endoscopic surgery, where you can contact a specialist nurse with any questions.