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EmtShirl Endoscopic Discectomy
is an outpatient surgical procedure to remove herniated disc material. Using local anesthesia with the help of x-ray fluoroscopy and magnified video for guidance, a small specially designed endoscopic probe is inserted through the skin of the back, between the vertebrae and into the herniated disc space. Tiny surgical attachments are the sent down the hollow center of the probe to remove a portion of the offending disc. The microsurgical attachments can also sometimes be used to push the bulging disc back into place and be used for the removal of disc fragments and small bony spurs.
The procedure takes about an hour, on average. X-ray exposure is minimal. You normally will feel little, if any pain or discomfort. There are no stitches. Upon completion, the probe is removed and a small Band-Aid is placed over the incision. The amount of nucleus tissue removed varies but the supporting structure of the disc is not affected by the surgery. The access route to the disc consists of only the probe's small puncture site, usually the size of a freckle, in comparison to large incisions required for open surgery.
Endoscopic Discectomy is different from open lumbar disc surgery because there is no traumatic back muscle dissection, no bone removal, or large skin incision. The risk of complications from scarring, blood loss, infection, and anesthesia that may occur with conventional surgery are drastically reduced or eliminated with this procedure. Endoscopic Discectomy was invented to be an effective treatment for herniated discs while avoiding these risks. A discogram
is a radiological procedure where x-ray dye (contrast agent) is injected into the disc space between two vertebrae of the spine. At the same time as the injection, the radiologist performing the study records any verbal comments the patient provides at the time of the injection. This tells the physician if that particular disc space is the reason the patient may be experiencing neck, back, or leg pain. The patient then turns in different positions while x-rays are taken to visualize the inner structures of the disc space. A myelogram
is diagnostic imaging test where fluid (contrast) is injected into the spinal canal so x- ray pictures of your spinal cord and nerves can be taken. The procedure may be done in a hospital or in an outpatient clinic, however, it is usually customary to remain for several hours afterwards to make sure there are no complications or reactions before you go home.
You are placed on an x-ray table and your back or neck is cleaned with a sterile antiseptic solution. The skin is then numbed with some medication and a needle is carefully inserted into the bony spinal canal. This is done under the supervision of fluoroscopy, which allows the radiologist who is performing the study, to precisely place the needle. Once the needle is in place, usually a little bit of spinal fluid is collected and sent to the laboratory for routine tests. Don't worry, only a small amount is collected, and since you normally make between a pint and a quart of spinal fluid every day, you won't even miss it. Once the needle is in place, the radiologist will then slowly inject the water-soluble contrast fluid into the spinal sac, which surrounds your spinal cord and nerves. After the appropriate amount of fluid has been injected, the needle will be removed and multiple x-rays will then be taken while you turn in a variety of positions.
Afterwards, it is not uncommon to follow the myelogram with a CAT scan to provide even more information to your physician. All this implies is that you simply lie on the CAT scanning table and further pictures are taken. Finally, when all is completed, you will be detained for several hours in an observation area or room for monitoring until you and the radiologist feel it is safe to leave.