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Old 03-04-2007, 12:07 PM   #1
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Endoscopic Microdiscectomy - opinions?

I'd like to hear what people think about the new minimally invasive procedure endoscopic microdiscectomy vs. microdiscectomy.

Has anyone here had the endoscopic procedure? Did it help you?

What is the recovery like for the endoscopic procedure? For the microdiscectomy? How soon were you able to eg. climb stairs, walk the dog, care for yourself without help?

I'd love to hear others' experience and thoughts on this.

Thanks!!

 
Old 03-04-2007, 04:53 PM   #2
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Re: Endoscopic Microdiscectomy - opinions?

Just had it done 4 weeks post op. I have had both the Endoscopic and the open discectomy, it was so much easier(Endoscopic procedure) In a couple of days I was feeling great, I haven't had any back pain in 4 weeks. My hip was sore for a couple of weeks. I did have a hypersensitive in the leg due to having nerve trouble for so many years, but I am begining to really feel good. I took tylenol for the first time for my pain. They also radiate the disc if you have tears in it. I have been able to stop taking Celebrex also. It was well worth doing the procedure. I have to have it done again in the summer to finish the last disc. They only do (my doctor) 2 at a time. The best thing is there is almost no scar tissue.

 
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Old 03-04-2007, 05:38 PM   #3
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Re: Endoscopic Microdiscectomy - opinions?

Let me make sure I understand this: an open discectomy is more invasive than a microdiscectomy, and a microdiscectomy is more invasive than an endoscopic microdiscectomy (or is it an endoscopic discectomy?).

picnica, are you basically off of prescription pain meds even though you had an open discectomy with significant scar tissue "grabbing" the nerves? That is awesome. Have you ever had a micro-discectomy? Thanks for reporting the good news!

 
Old 03-04-2007, 06:26 PM   #4
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Re: Endoscopic Microdiscectomy - opinions?

An Open or Mast microdiscectomy is when they use a tube to go down through your back, drill out the bone and remove the fragment. I have seen it on a couple of spine websites as both names. The second one (Just done) is a Endoscopic Microdiscectomy or Selective Endoscopic discectomy or Endoscopic Pertanious discectomy. All of them seem to be the same, the procedures are exactly the same. Instead of drilling the bone in the back, they can go into the side by the hip and use a small cut, or they send down a guide wire and streach the skin and muscle. Then either laser or radiate the disc to shrink it and seal the tear. I have been on pain meds for 8 years. I have 5 ruptured disc 3 of them are causing me pain at the moment. From 22 to 28 I just went to the Chriopractor and sometime anti inflammatory meds. Then 28-30 I had bad pain and the surgeon I was using just did MRI's and a wait and see approach (Meds.) Around 30 I had my first fragment break off, it caused drop foot and numbness in the leg, I was having trouble urinating. I was in surgery 6 hours later and had a Laminectomy/Discectomy (Mast system) I didn't have time to research it. I never got allot better, I still have foot drop and numbness. But the surgeon wanted to wait and see. Finally, I started to get other opinions. I went through 4 more doctors "protocalls" It took 4 years of epidurals (12) and PT. The epidurals would only work for 2 months than 2 weeks. Then, both legs started to give me trouble and then my groin. Finally I saw a doctor who was not into pain meds but was into listening and was willing to try the surgery.
Now, I am not going to be pain free, that would be silly,
My good days are good. My bad days are better. The nerve pain from the surgery (common occurrence after that procedure) is getting better. I still have the foot drop but, I am able during the day to take Tylenol, but at morning and night at my worse I still am taking Darvocet. Better than taking percocets for the last 4 years. Comparing both surgeries, if you fit in that surgery, it was much better than the first one. Hope this clarifies my other post.

 
Old 03-04-2007, 06:40 PM   #5
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Re: Endoscopic Microdiscectomy - opinions?

Picnica,

How bad is your foot drop? I have it too, but in a mild form. I can lift my foot and move my toes normally, but I don't have much strength in my toes. Makes me limp because I can't push off with the toes on my left foot when walking.

 
Old 03-07-2007, 01:44 PM   #6
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Re: Endoscopic Microdiscectomy - opinions?

Good post...

To Cythren: What has your surgeon said about getting surgery? If you have lost strength to the point that you are limping & you have tried PT with no results if I were you I would be looking at surgery.

How long have you been limping?

How old are you?

Let me know & take care... Dave!

 
Old 03-07-2007, 04:19 PM   #7
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Re: Endoscopic Microdiscectomy - opinions?

When the surgeon did the test on my foot, he told me that the damage was done before my first operation so this wouldn't help. If it was fresh injury I would have had a better shot. As far as how bad is the foot drop. I can only pull the foot up with light shoes. Like today, it snowed. I cannot wear boots or I walk like Frankenstein. I have no Achilles reflex. (Ankle) My toe only works going down, it cannot go up, which isn't so bad. Now I am sure in a couple of months it might improve. But it only will improve slightly. I just had a post MRI, I will be interested on Friday the before and after pictures. I will let you know.

 
Old 03-07-2007, 04:37 PM   #8
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Re: Endoscopic Microdiscectomy - opinions?

Picnica,

Yes, please do let us know what your new MRI looks like. I'm curious.
So your foot drop happened a long time before your recent surgery?

I too have no ankle reflex on the left side. Doc said it probably won't come back, but that doesn't seem to be an obstacle to normal functioning of the foot. As long as the foot works normally, who cares if there is a reflex or not, right?

Sorry for all the questions

Dave,

I'm 38 and this is the first time I've ever had really debilitating back problems. I've had lower back pain off and on for about 15 years, but I never saw a doctor for it and just used heating pads, stretching and advil to help with the pain.

This time was different. I couldn't walk, sit or stand and the pain was way worse than before. It started in the beginning of December, so I've had this bad disc herniation for 3 months now. Had the MRI on january 30th and it showed a large paracentral herniation "impressing on the left ventral aspect of the thecal sac" at L4-L5. I also learned that the disc below, L5S1, is degenerated. Those are the only two that are messed up.

The neurosurgeon I saw in early February told me I needed surgery, but that was based on the severe pain I was in at that time. When he examined me, he said I had weakness in my big toe.

The pain went away four days before surgery, so I called him to see about postponing surgery. He said the pain going away was a good thing, and that it would be reasonable to hold off on surgery. It's been three weeks now and the pain hasn't come back.

I've got to run now but I'll tell the rest of my story later. I have other reasons for avoiding surgery too - no insurance, lost job due to back injury in December, and nobody to help me out post-surgery. Sigh.

- Cythren

Last edited by cythren; 03-07-2007 at 04:38 PM. Reason: typo correction

 
Old 03-07-2007, 08:23 PM   #9
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Re: Endoscopic Microdiscectomy - opinions?

If your herneation is three months old, wouldn't there still be a chance of improving the toe strength with surgery? However, my reflex was poor at 4 months with diminished strenth in my toe, and I have had improvement in those areas without surgery. I hope you do to. Does the surgeon you are seeing do endoscopic discectomies. Is there a place to send MRI's to get an evaluation to see if the endoscopic procedure would be appropriate?

 
Old 03-08-2007, 01:22 AM   #10
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Re: Endoscopic Microdiscectomy - opinions?

Well, it's 4am and not sleeping but this time it's cause I have a headache. To answer your question. I have a "mild herniation at L-2/3 a Partial natural fusion at L3-4. I had the fragment 4X8mm removed in that canal area. The full fusion could take another 2 yrs. to complete. (just had a MRI yesterday morning it looked about 3/4) Grade 4 tear and bluge at 4/5 (just operated on so I don't know if the large bulge is there) Grade 4 tear at L5-S1 and also medium bulge. (same as above) There is DDD from L3-S1. Scar tissue is everywhere (endoscopic picked it up) Osetoarthritis L-3-S1. Spinal stenosis L-4-S1. I have (before surgery) 60-70% strength on the right foot with no movement upwards on the entire right foot. Not that is a huge problem. You can still do most things. I am sure I missed something. Not bad for 35. I didn't even have a car accident. Hope that helps you decision.

 
Old 03-08-2007, 05:41 PM   #11
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Re: Endoscopic Microdiscectomy - opinions?

[QUOTE=Davesport;2844211]If your herneation is three months old, wouldn't there still be a chance of improving the toe strength with surgery? However, my reflex was poor at 4 months with diminished strenth in my toe, and I have had improvement in those areas without surgery. I hope you do to. Does the surgeon you are seeing do endoscopic discectomies. Is there a place to send MRI's to get an evaluation to see if the endoscopic procedure would be appropriate?[/QUOTE]

Davesport - Good to hear you had some improvement in toe strength at 4 months without surgery...The neurosurgeon I saw upstate a month ago has a great rep and is very experienced, but it wasn't clear to me if he did micro- or open discectomy. Definitely not endoscopic procedures. I only spoke to him for about ten minutes, and at that time he said a 2" incision, and handed me a booklet called "lumbar microsurgery". Couple days later I called to get clarification of what they were going to do, and spoke to the PA. She said, no - the incision would be 4" and that they don't do microsurgery, only open. It confused me. They also used discectomy and laminectomy interchangeably.

My plan now is to wait and see until April, then see another surgeon here in NYC who I know does the minimally invasive procedures if there's no improvement.

- C

 
Old 01-07-2008, 11:38 PM   #12
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Re: Endoscopic Microdiscectomy - opinions?

Picnica,

Where did you have your endoscopic surgery? You didn't by chance go to a certain place in Arizona? I've been thinking about going there as I have two discs that are badly torn discs...annular disc tears, according to discography,...and i understand the only other traditional treatment would be a 2 level fusion. I know that the IDET was done for these, but the results haven't been very good. I would like to contact the clinic and get a list of some names that have had this treatment for disc tears only.

 
Old 07-22-2010, 08:54 PM   #13
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Re: Endoscopic Microdiscectomy - opinions?

I just met with a pain doctor in NJ that does an endoscopic procedure. How is a pain Dr qualified to do a microdisectomy isn't this neuro or ortho? I am really scared of the microdisectomy that I am scheduled for in NYC. Does anyone else have any positive results from this endoscopic procedure?

 
Old 07-23-2010, 06:19 AM   #14
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Re: Endoscopic Microdiscectomy - opinions?

I am not sure, I know my pain doctor was a trauma surgeon for many years, he is in brick, nj. He was one of the first to do the endoscopic disectomey. I have had both kinds and the endoscopic disectomey is a piece of cake.

 
Old 07-23-2010, 07:56 PM   #15
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Re: Endoscopic Microdiscectomy - opinions?

[QUOTE=picnica;4292417]I am not sure, I know my pain doctor was a trauma surgeon for many years, he is in brick, nj. He was one of the first to do the endoscopic disectomey. I have had both kinds and the endoscopic disectomey is a piece of cake.[/QUOTE]
Picnica,

did you have any complications from the endoscopic and how was your recovery? I am 29 and I am bringing my parents with me to brick this week to help make the final decision. The endoscopic surgery would be the following week-Aug. I feel like the microdiscectomy that i am scheduled for will just lead me on the path to future surgeries.
What did you do to feel at ease with the endoscopic procedure? Did you research, talk to previous patients? What sold you on the endoscopic option?

 
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