Spinecare Topics

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Options for Spine Treatments
Advancements in Spine Care and Spine Surgery

Endoscopic Microdiscectomy

Microdiscectomy refers to a procedure used to remove herniated disc material that lies in the spinal canal adjacent to a nerve or the spinal cord. The procedure usually requires the removal of a segment of bone (laminectomy) creating an operative window requiring an incision approximately one to two inches long. In some cases the surgical incision may be longer. The traditional laminectomy and microdiscectomy is performed with external visualization of the surgical field magnified with an operating microscope.

An endoscopic discectomy refers to the surgical removal of an intervertebral disk using an endoscope. An endoscope is a device that utilizes a tube with an optical system mounted at the end of it. This small optical system can be inserted through a relatively small incision or puncture opening and is used to guide the operative procedure.

Endoscopic microdiscectomy is often performed as an outpatient surgical procedure. On the average, the procedure performed at one spinal level takes about an hour. X-ray exposure is minimal. An individual may experience a little pain or discomfort after the procedure. The amount of disc material removed will vary from patient to patient. The overall supporting structure of the disc is not compromised by the procedure. During endoscopic microdiscectomy the window of access and the access route to the disc consists of only the probe's small puncture site, usually the size of a large freckle.

An endoscopic discectomy is less invasive than open lumbar disc surgery. Sometimes a surgeon may prefer an open surgical procedure so that they can better visualize and investigate the area in question or to perform the procedures necessary. An open incision may be required to perform additional procedures after microdiscectomy. The endoscopic procedure does not typically require back muscle dissection or bone removal. A large skin incision is usually not necessary. The risks of complications from scarring, blood loss, infection, and anesthesia that may occur with conventional surgery are reduced with endoscopic microdiscectomy. There are generally no stitches used. Endoscopic microdiscectomy may not require general anesthesia. Most patients are discharged within a few hours of the procedure. A band aide or butterfly is often used to close the skin entry site.

Intra-Operative Neurophysiological Monitoring

When surgery on or near the spinal cord or spinal nerve root is required, careful neurophysiological monitoring of spinal function during the operation can be performed. Intra-operative neurophysiological monitoring encompasses a variety of procedures that have been used to monitor the integrity of neural pathways during high-risk neurosurgical procedures that could result in damage to the nervous system.

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To learn more about your spine. spinehealth, and available spinecare go to the International Spine Assocition (ISA) at www.spineinformation.org. The primary mission of the ISA is to improve spinehealth and spinecare through education. The ISA is committed to disseminating need-to-know information throught the World Wide Web in numerous languages covering many topics related to the spine, including information about spine disorders, spine heath, advances in technology and available spinecare



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