Neurológia pre prax 5/2024

Spinal endoscopy – treatment of the lumbar disc herniation

From the works published so far, the endoscopic spine surgery of the lumbar spine has its justification. Miniinvasive approach spares muscles, minimizes postoperative pain, shortens hospitalization and of course recovery. It proves the results of our patients after disc herniation treated by endoscopic surgery. In patients we register less postoperative pain, less consumption of analgesics postoperatively, early verticalization and early return to everyday activities. We evaluate the endoscopic discectomy (interlaminar and transforaminal) as an efficient surgical method in treatment of lumbar disc herniation in cases such as radiculopathy, hyperalgic conditions even in cases with motoric deficit. Ideal candidates for lumbar spine endoscopy are patients with discogenic radiculopathy with early symptomatology where we predict soft disc herniation. In these cases, we choose the endoscopic discectomy as a first choice of treatment. Our purpose is to continue in education of spinal endoscopic procedures. We are reducing the amount of recurrent disc herniations with increasing skills. We enrich our experiences in other parts of spine such as cervical spine in treatment of cervical radiculopathy. In March 2023 we implemented the first cervical spine endoscopy, where the main purpose was to decompress the cervical spine nerve which was compressed by cervical disc herniation. In the future we plan to expand in indications criteria, even in cases of degenerative spine disorders, implantation of intervertebral disc cages with transpedicular stabilizations.

Keywords: spine endoscopy, microscopic discectomy, mimiinvasivity, indications, rehabilitation, early mobilization