1. Technical points.
A minimally invasive working channel (7mm) is placed into the body through percutaneous puncture and stepwise expansion under X-ray surveillance, with the herniated lumbar disc in front of the channel. Then the intervertebral foraminoscope is placed through the working channel, and after connecting the light source and camera device, the herniated disc and surrounding tissues in the spinal canal can be magnified and imaged through the endoscopic imaging system, and then the disc is removed and the nerve roots are released through the working channel of the endoscope.
2.What cases are suitable for this technique?
Patients with herniated discs whose back pain is not severe, but whose lower extremity symptoms such as pain and numbness are severe
3.What are the advantages of this technique?
Truly minimally invasive technique: the skin incision is only 8mm and there is almost no damage to the anatomy of the lumbar spine (only a very small amount of the superior articular process is removed).
Fast recovery of the patient: he can get out of bed after the operation and return to normal work completely 1 month after the operation.
Short hospital time: 2-3 days.
4.What is the safety of the technique?
Operation under local anesthesia, with less impact on systemic organs and systems
Operation under local anesthesia: effective feedback can be obtained for any harassment of the nerve, and it is extremely difficult to damage the nerve root.
Having a special electric knife for microhemostasis, complete hemostasis and no obvious hematoma formation.
The puncture process is closely monitored, and the chance of accidental puncture injury can be strictly controlled to a minimum.
Our newly introduced Maxmore system replaces the previous ring vise for expanding the bone channel with a blunt-tipped, blunt-toothed threaded drill, which greatly avoids the possibility of nerve and dural injury.
5.Is the pain of the surgery serious?
Mild pain and discomfort mainly occurs during the puncture procedure, with some auxiliary analgesic measures, the patient’s pain is within the tolerable range.
6.Is there any recurrence after the surgery?
There is a certain recurrence rate after surgery. The main purpose of the surgery is to remove the discs that protrude into the spinal canal and compress the nerves, without deliberately dealing with the unprotruding part of the disc, so there is a certain recurrence rate, but it is not higher than the traditional laminectomy.
7.What are the current techniques for lumbar disc removal through the intervertebral foramen?
The YESS technique, which aims to enter the intervertebral space to remove the disc and indirectly decompress the herniated disc, and the TESSYS technique, which aims to enter the spinal canal to remove the herniated disc
8.What are the differences between this technique and minimally invasive techniques such as ozone, collagenase and radiofrequency ablation?
Endoscopic lumbar disc removal through the intervertebral foramen is a real surgical technique, especially TESS technique is a direct decompression technique, which is especially suitable for large herniated discs with obvious symptoms; ozone, collagenase and radiofrequency ablation are indirect decompression by removing part of the disc tissue in the intervertebral space through physical or chemical methods.
9.What are the precautions after the surgery and discharge?
Do not bend and twist your body excessively within 1 month after surgery, appropriate lumbar girth protection, do not bear weight, but you can complete daily light work such as driving a short distance.