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Auther : Vidya Jagtap Date : 2021-03-27 12:46:20

Category : Procedure


Operative procedure of Percutaneous Endoscopic Lumbar Discectomy

Find affordable and low-cost Percutaneous Endoscopic Lumbar Discectomy In India. Percutaneous Endoscopic Lumbar Discectomy is carried out by a spine surgeon.


Percutaneous Endoscopic Lumbar Discectomy is an advanced/modern type minimally invasive spine surgery. With the help of a posterolateral approach, it decompresses the lumbar disc and removes the nuclear pulpous. Percutaneous Endoscopic Lumbar Discectomy is an endoscopic surgery conducted through a percutaneous route that removes the slipped disc material. It falls under the daycare treatment in which a small incision is made through the skin without cutting or harming the bone or muscle. Percutaneous Endoscopic Lumbar Discectomy is carried out by a spine surgeon. Book an appointment with the best hospitals or top surgeons in India. Get detailed information about spine surgery in India and find the list of spine surgery hospitals in India at HMSDESK.

PELD is an excellent treatment choice for spinal tumors and structural deformities in patients whose pain threshold is less or patients who are less responsive to conservative treatments like pain killers, anti-inflammatory drugs, etc. It is not a Conventional excision but a procedure in between conservative and open surgery. So, it doesn’t harm the normal soft tissue or the vertebral structures. After introducing a thin wire into the skin, under endoscopic guidance, the surgeons treat the herniated disc with laser and radio-frequency thermal effects.

The procedure is performed under local anesthesia. The surgeon makes a percutaneous incision and introduces a needle between the vertebrae and into the middle of the disc that dilates the path into the disc space. The surgeon then inserts the endoscope through this dilated path. Under endoscopic guidance and visualization, the surgeon removes or melts herniated disc material with the help of forceps, radiofrequency probe or laser.

The entire endoscopic spine surgery procedure is patient-friendly in which spinal herniation and bony constriction can be taken off, by preserving the neighboring tissues. The procedure relieves the pressure acting on the nerve, stops the inflammatory response, and eliminates the pain.

Symptoms

General symptoms of PELD includes the following:

  • Persistent pain in the lower back
  • Radiating leg pain
  • muscle weakness
  • bladder problems
  • Numbness around the lower limbs
  • Inability to stand up
  • difficulty in walking

Diagnosis

These are few perioperative diagnostic tests that are required for the indication of percutaneous discectomy.

  • X-ray
  • CT Scan
  • MRI
  • Myelo-CT
  • Myelography
  • Discography and Disco-CT

Procedure Of Percutaneous Endoscopic Lumbar Discectomy

It’s minimally invasive spine surgery. It is an endoscopic surgical procedure that is conducted/performed under local anesthesia with mild sedation. The exact entry point is mapped on the patient’s body using an image intensifier X-ray system by making them lie in the front. From the midline on the posterior part of the body, a small incision of about 8-10 cm is made. The intervertebral disc material can be removed in 2 different ways:

1) Automated Percutaneous Discectomy (Manual procedure) involves, directly inserting a long spinal needle from the side of the back into the disc, by-passing other bone, and ligaments. With the help of this needle, the guidewire is passed and after forming a 5 mm incision, a dilator and working cannula are passed, through which an endoscope is inserted. With the guidance of the camera and monitor attached to the endoscope the prolapsed part of the disc is removed.

2) The laser surgery, referred to as Percutaneous Laser Discectomy (PLD), uses an external imager called the fluoroscope to direct the probe. Decompression of the nerve root and vaporization of a part of the intervertebral disc material is achieved with the laser energy delivered by the probe.

Risks Associated With Percutaneous Endoscopic Lumbar Discectomy

  • bleeding
  • infections
  • tears in the spine’s protective lining
  • injury to the nerve

Advantages Of PELD

  • Minimal anesthesia-related complications
  • Lower risk when compared to open surgery
  • Lesser injury to the muscle, adjacent tissues or bone
  • normal disc structure is protected
  • preventing postoperative spinal instability
  • Faster pain relief directly after surgery
  • Lesser post-operative pain
  • Daycare procedure
  • Faster recovery and quick return to work and social life
  • elderly and diabetic patients can tolerate this procedure
  • Smaller incisions (5-6 mm)
  • cosmetically better
  • minimal scar formation
  • Minimal blood loss

Recovery After PELD

Since PELD is a daycare procedure, patients can return on the same day after the procedure. An individualized rehabilitation program in cases of muscle weakness can also be advised by the surgeon. Generally, within 4 – 6 weeks the patients are expected to return back to their normal life.

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