Endoscopic Disc Removal / Disc Prolapse Surgery

Disc prolapse is a condition in which there is a break in the harder outer area of the disc, and jelly-like material comes out and causes pressure on the nerves. All of the pressure arises from the pressure on the nerves. Disc prolapse is also the most common cause of sciatica pain.

The symptoms related to disc prolapse in the low back are:

• Pain and stiffness of the low back
• Numbness, tingling, the feeling of pins and needles, crawling of insects or loss of feeling of touch from back till foot, shooting pain like current flow or burning sensation from back travelling till foot.
• Difficulty in performing daily activities like
  a) Driving
  b) Difficulty in walking
  c) Sitting for a long time
  d) Bending to lift objects
  e) Coughing or sneezing or applying pressure using the washroom increases pain
• In very severe cases, loss of bladder and bowel control
• In severe cases, muscle weakness

Risk factors for disc prolapse include:

• Earlier injury to the back
• Stress to the back like heavy weight lifting, manual work, abnormal sleep posture
• Looking at a particular point for a long time like computer working, painting, reading, or mobile use for long hours without maintaining proper position.
• Driving for very long hours

Disc prolapse can occur suddenly and be very severe, so much so that the patient cannot stand from bed or walk. It can also develop slowly over time. It depends on why disc prolapse occurs; if it is due to injury, it can cause sudden pain. In arthritis and other degenerative diseases, spine disc prolapse takes longer and increases pain over time.

If pain has started in the back and goes down to the legs with pain in the buttocks, it can be due to disc prolapse. But if the pain is present in the groin or at the hip, which increases with movement at the hip, it is due to the hip. Kindly consult the doctor to know the difference.

Disc prolapse is identified or diagnosed as follows:

• Physical examination with a detailed history to find the cause of sciatica pain.
• X-rays of low back
• Computed tomography (CT) scans.
• MRI
• EMG
• NCV
• Myelogram (type of CT scan)

Disc prolapse can arise because of several causes and can occur at any age.

• Maintain Good Posture. Place computers and phones so that there is no pressure on your back while using them. Keep back straight when seated and use the arm-rest. While driving, maintain good posture. Keep your elbow, wrist, and hand straight. Use a mouse for computers instead of the touchpad and keep the screen at the level of eyes.
• Sleep Correctly so as Not to Strain Back. Use a pillow for head support; the head and neck should all be aligned. Place a pillow below the knees; it removes pressure from the low back.
• Take frequent breaks to move around and stretch your body. If working for a long time in a sitting position, stretch back every hour.
• Avoid heavy weight lifting on the head and shoulders.
• Avoid lifting heavy weights using bending your back; instead, bend your knees and lift.
• Exercise regularly, do yoga or join physiotherapy sessions to strengthen back muscles.
• Don’t drive for very long hours continuously; take breaks in between.

Many patients 80-90 % are treated without surgery, and the results are good

• Rest
• Physiotherapy
• Hot and cold massage treatment
• Painkillers and muscle relaxants
• Use of a lumbar brace

Many patients will be treated with this treatment only; consult your surgeon and follow the advice.

If pressure on the nerve is severe, it may damage the nerve. This will cause a FOOT DROP condition in which it will be very difficult to walk normally, and severe damage may result in lower limb loss of sensation depending on the nerve root affected. In very severe cases, bladder bowel control loss will occur. Consult with your surgeon about low back pain, which lasts for a long duration.

In cases where the patient has taken treatment for more than three months, it is called chronic pain. Consult your surgeon immediately.

Surgery is done in the following cases:

• After taking treatment for a long time, the problem is still there.
• The patient is not able to perform daily activities because of pain.
• Problems like weakness of legs, loss sensation of touch, unable to control bladder or bowel, thinning of legs muscles.
• Difficulty in maintaining balance or walking

A final decision has to be taken in consult with a surgeon

The role of surgery is to remove pressure from the nerve. Endoscopic disc removal surgery involves the removal of a portion of the disc that is causing pressure on nerves.

Endoscopic disc removal is a minimally invasive spine surgery with small cuts/incisions. Endoscopic disc removal involves giving a very small cut in the back and using a camera and other instruments to remove the disc portion which is causing the patient's problem. Since the cut is very small and less damage to the surrounding structure is done, recovery is fast, and the patient returns to normal life fast. Kindly consult with the surgeon before surgery.

The main problem with disc prolapse is caused by the portion of the disc causing problems. So only a portion of the disc is removed to keep NATURAL SPINE SHAPE. Other structures are not damaged. This helps in

• Spine remains stable
• Risks of surgery are less
• In complete disc removal, spine bones will have to be fused to maintain the stability of the spine
• Faster recovery

Usually, a patient has to stay for 1-2 days.

Endoscopic Disc removal surgery with new technologies and a better understanding of the problem and use of MINIMAL INVASIVE SPINE SURGERY is routinely performed worldwide with a good success rate. Final results depend on the patient's condition, so consult with the surgeon.

Recovery usually takes 3-4 weeks, after which the patient will join light duties. For complete recovery, it will take 2-3 months.

Very next day, with the help of some assistance and after a review with the doctor and physiotherapist, the patient will be allowed to walk.

The complications of endoscopic disc removal surgery involves:

• Infection
• Injury to nerves and spinal cord
• Damage to the dura
• Failure to correct problems for which surgery was done

It depends on the hospital category chosen by the patients. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com, we believe that a patient requires expert care within the most comfortable surroundings until he/she can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included endoscopic disc removal surgery.