Disc surgery and having to lie down for 1 month? Not all of it! Disc surgery, to lie down for 1 month? Not exactly! The incision is only the size of a keyhole, and you can get off the floor 1 day after surgery It seems that there are many people around us who have herniated lumbar discs, and a few of them have not been cured for a long time, and in the end, they only have to turn to orthopedic surgeons for surgery. However, many people are very afraid when they hear about surgery, making incisions in the back, biting the bone, and staying in bed for a long period of time after the surgery (unless a steel plate is played), which is scary to think about. Now the good news is that the Department of Orthopedics of the Third People’s Hospital of Anji County has introduced the world’s most advanced minimally invasive spinal disc surgery – intervertebral foramenoscopy surgery since 2014. Dr. Jiang Hui, chief physician of the department, said that this kind of surgical incision is only 7.5 millimeters, and you can get off the floor the next day, with little trauma and fast recovery. Anji Hospital also carried out another minimally invasive surgery called “discoscopy”, the incision is a little larger than the intervertebral foramenoscopy, 2 centimeters. Anji Hospital is also the only hospital in Huzhou City that independently carries out both intervertebral foramenoscopy and discoscopy minimally invasive surgery. Fifteen-year-old Wang, still attending junior high school, recently accompanied by his parents to the orthopedic department of Anji Tri-Institute for review, feeling very good. Originally, 1 year ago, he suddenly felt intolerable pain in his lower back and soreness and pain in his left lower limb after a physical education class. He was diagnosed with lumbar disc herniation after doing CT in the hospital. Doctors advised him to rest, bed rest, medication and physical therapy. A few months later, his symptoms still gradually worsened and he developed numbness in his left lower limb to the extent that he could not study normally. Wang’s parents were very anxious, knowing that even if he stayed in school, there was no guarantee that he would be able to go to school next year, and delaying was not an option. However, they were very hesitant when they heard that surgery would be very risky and that they would have to rest for a long time. Under the apprehension, Wang’s parents came to Anji County Third People’s Hospital, orthopedic chief Dr. Jiang Hui helped them to analyze Wang’s condition in detail, that despite the young age, but if the delay may even be difficult to guarantee the midterm examination, or surgical intervention. Finally, a minimally invasive surgical method was chosen for them – intervertebral foramenoscopy under local anesthesia. As soon as he came down from the operating table Xiao Wang felt that his back and leg pain disappeared, and he went down to the ground the next day and was discharged from the hospital three days later. What are the treatments for lumbar disc herniation? Dr. Hui Jiang, Chief Physician: A complex project. It is roughly divided into conservative, intervention and surgery. Conservative methods include rest, lumbar circumference, traction, three-dimensional traction repositioning, acupuncture and massage, knife, Chinese and Western medicines, closure, epidural drip, etc. 80-90% of the patients can be cured or improved for a long time through conservative treatment. Interventions include percutaneous suction, ozone ablation, etc. Surgical procedures include minimally invasive (intervertebral foramenoscopy, discoscopy) and open surgery (including small incisions, conventional incisions, and the addition of fusion internal fixation – i.e., plating, etc.). All of the above methods are routinely performed in our orthopedic department, from the smallest to the largest, from the simplest to the most complex, and encompass almost all of the disc treatments. What kind of surgery is intervertebral foraminoscopy? Hui Jiang: The traditional surgery is to make an incision from the middle of the back to enter the intervertebral disc, most of which needs to bite off part of the bone, which is more damaging to the tissue structure, so the postoperative bed rest is longer. Intervertebral foraminoscopy is a procedure that enters the disc from the lateral side of the back, makes a 7.5 mm (the size of a small keyhole) incision under local anesthesia, places a tube near the disc under fluoroscopic positioning on a mobile X-ray machine in the operating room, and then connects the lighting and imaging equipment so that the surgeon can look at the monitor (as if he were watching TV) to complete the surgery through a variety of complex and delicate instrumentation. Can foraminoscopy solve all disc surgeries? Hui Jiang: Not yet. I often say to patients, herniated discs are all kinds of, disc treatment is all kinds of, that is, the surgical method is also all kinds of. Whether a patient is conservative or surgical, and what method is used for surgery, needs to listen to an extremely experienced doctor’s opinion. Intervertebral foraminoscopy has its indications, so, so far, we still have a lot of patients who have traditional surgery, and some of the complicated patients we have to do a large incision to fuse off the intervertebral space, and then put a steel plate on. In short, there is no one solution to all problems. Is it safe to operate on the spine with so many neurovessels? Jiang Hui: Any surgery has risks, and spinal surgery can’t avoid important neurovascularity, so of course there are risks. Intervertebral foramenoscopy surgeons need to have rich experience in open surgery and microscopic (looking at the monitor) operation. In fact, in 2009, we carried out percutaneous suction treatment of intervertebral discs, is the predecessor of the intervertebral foramenoscopy, at that time is the X-ray machine under the guidance of the “blind do”, the risk is relatively large, now added a mirror, looking at the “TV” to do, the nerves magnified very clear, and safer. It is safer.