Selective Endoscopic Discectomy
This minimally-invasive procedure is performed
through a small tubular device. It is designed to
relieve pain caused by herniated discs pressing
on nerve roots. The surgery is performed under
local or epidural anesthesia, allowing the
patient to leave the hospital the same day.
Guide Wire Inserted
After the disc protrusion is confirmed, a guide
wire is inserted to the affected disc. The
surgeon uses a special type of x-ray machine
called a fluoroscope to ensure that the route to
the herniated disc is made in the correct
A two-hole obturator tube is passed over the
guide wire to push apart the tissue down to the
disc and to move the nerve root out of the way.
Painful tissue in the path of the obturator may
Working Sleeve Inserted
The working sleeve, through which the surgery
will be performed, is slid over the dilating tube.
It is positioned on the disc surface. The guide
wire and dialator are then removed.
An endoscope (which contains a surgical light
and small camera) is placed through the tube,
allowing the surgeon to view the annulus, disc,
and epidural space on a video monitor. The
surgeon will use the endoscope to guide the
surgical tools and inspect the results.
Degenerative Portions Removed
The surgeon uses instruments to remove
degenerative and extruded portions of the disc
nucleus. Because only enough of the disc is
removed to reduce pressure inside the disc, the
spine remains stable.
Disc Wall Treated
The disc wall defect is treated with a laser and
radiofrequency probe. The foramen and nerves
are inspected to confirm successful
decompression. The instruments and sleeve
End of Procedure
The insertion area in the skin is covered with a
small bandage. Because no muscles or bone
are cut during the procedure, recovery is fast
and scarring is minimized. The patient may
need a day of bed rest after the procedure and
physical therapy. Most patients may return to
normal activity within one to six weeks.