Introduction to Percutaneous Endoscopic Lumbar Discectomy

About Human Spine

Human spine is a long column made up of thirty three vertebrae which are interspaced with discs. These discs act as cushions and help the spine to do all its cavities without any rubbing between the vertebrae. The spine is divided into three parts known as cervical spine, thoracic spine and lumbar spine. The portion connected to the brain and containing 7 vertebrae is known as cervical spine. The portion below the cervical spine containing the next 12 vertebrae is known as thoracic spine and the last portion containing the next 5 vertebrae is known as lumbar spine.
Percutaneous Endoscopic Lumbar Discectomy Diagram

Why Percutaneous Endoscopic Lumbar Discectomy Surgery is performed?

As a person ages the water content in the disc reduces. This causes the disc to become brittle and at times cracks are formed on the circular outer part of the disc known as annulus fibrosis. The gel like substance in the inner part of the disc known as nucleus fibrosis flows to these cracks and this causes hernia or bulging of the disc. The bulged or herniated disc touches the spinal cord and spinal nerves coming out through the small holes on the left and right side of the vertebrae. This causes severe pain in the back and the area where the spinal nerves are communicating to.
Conventional treatments like medication, physiotherapy, wearing braces, taking bed rest etc can be useful in milder cases of disc bulging and herniated discs. But in severe cases these types of therapies are not sufficient to give any appreciable relief. Removal of herniated disc portion and bone spurs through surgery is the only cure for bulging discs or herniated discs

What is Percutaneous Endoscopic Lumbar Discectomy?

In this surgery the introducer needle is inserted into the artery through a small incision in the backside of the patient under local anesthesia. A needle is passed through this introducer and guided with a help of fluoroscope till it reaches the lumbar disc which is herniated. Through this needle a contrast dye is injected into the nucleus pulposus which consists of a jelly like substance. This dye helps to get a clear picture of the hernia of the disc through MRI scan. Using the needle the herniated disc is aspirated. As the aspiration is continued the herniated disc is pulled back to its normal position. When the bulging of disc has reduced its touching and consequent pressure on the spinal cord and nerve roots is reduced relieving the pain completely or to a considerable extent. After this the needle and the introducer are taken out.