Do you know about - Selective Endoscopic Discectomy: extremely Minimally Invasive surgery
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We had a good read. For the benefit of yourself. Be sure to read to the end. I want you to get good knowledge from Outpatient Surgical Center.While 95% of citizen who withhold an injury to their lower back will recover with a blend of conservative treatment and deterrent measures there is a small group of patients who fail to sass to these measures.
This record is meant for those patients who remain unhappy with their symptoms and have been advised by their treating physicians that they would have to live with their gift symptomatology or undergo total spinal surgery. The following data is about Selective Endoscopic Discectomy an alternative policy for those patients who do not want to live with lasting pain, undergo total spinal surgical operation and do not want to have general anesthesia.
The typical sick person often presents some months or more after having sustained an injury to the lower back with no previous history of any back problems. Introductory treatment from the general practitioner, chiropractor or crisis room doctor might consist of that the sick person take anti-inflammatory medication, analgesics, muscle relaxants, limit activities and receive physiotherapy. When the patient's qoute did not conclude the sick person may have been sent to an orthopedic or neurosurgical master who scheduled the sick person for an Mri scan that may have revealed one or multiple disc bulges, disc protrusions or disc herniations. The sick person may have been provided with further treatment in the form of a lower back brace and a series of epidural cortisone injections along with definite trunk/abdominal/lower back stabilization exercises or Pilates exercises. While the sick person may have noticed some partial revision with any or all of the above measures he or she may have essential residual lower back pain and radicular pain into one or both of the legs. At that point the sick person may have been told that surgical intervention would be essential in the form of either a micro lumbar laminectomy or a Metrx discectomy under general anesthesia or if the qoute was more total that a spinal fusion or disc exchange surgical operation might be indicated.
At that point after acceptable quote of the patient's history and performing a unblemished corporal test and discussing the patient's Mri scan I might find that the sick person could be a candidate for the Selective Endoscopic Discectomy policy if the sick person was found to have either a contained lumbar disc protrusion or lumbar disc herniation unassociated with elements of severe arthritic changes. At that point we would suggest to the sick person that further confirmatory testing be performed in the form of a provocative discogram to conclude the exact disc that is causing the residual pain and then consequent the discogram with a Selective Endoscopic Discectomy procedure.
A discogram is an X-ray study performed under flouroscopic control in an sick person surgical town using local anesthesia. A needle is located in the town of the abnormal disk and in an adjoining general disc and a solution consisting of X-ray incompatibility dye mixed with indigo Carmine blue dye is injected into these discs. Since the sick person is awake as the dye causes increasing pressure in the town of the disc most likely this will reproduce the sick person symptoms in the back and/or leg pain and also define the abnormal anatomy of the damage disc on the floroscope. If the patient's symptoms are reproduced by this discogram it is considered a unavoidable concordant discogram and the sick person can then be treated with the Selective Endoscopic Discectomy either immediately or at a later time if insurance authorization is required.
The Selective Endoscopic Discectomy policy is then performed under local anesthesia with the sick person awake and in the prone position on extra pillows. A small needle is inserted into the disc space after local anesthesia has been administered. A 7mm (1/4inch) skin incision is made and a spine arthroscope is slipped into the abnormal disc. Under fluoroscopic control, the micro-instruments (mini forceps, mini curettes, and mini cutters-shavers) and the laser probe are used for removal of only the damaged disc material. The laser is used for further removal and shrinkage of the disc for the purpose of disc decompression and tightening up of the annulus. The policy takes about 30 minutes to an hour per disc, on the average. The amount of disc removed and shrinkage by the laser varies, but includes only the herniated and damaged portion. The supporting buildings of the disc is not affected. Upon completion, the probe is removed and a small Band-Aid is applied over the needle incision. Since the sick person is awake while the policy often they are concerned in watching the monitor as we take off the damage disc material.
After surgical operation the sick person is sent home and advised to use ice packs on the lower back and take mild oral analgesics and rest for few days. Many patients are able to resume work within a few days. The sick person are advised prior to the policy that if the preoperative pain was primarily lower back that in excess of 86% good and perfect results should be expected. If the patient's pain was back and leg pain good and perfect results should approach 92%.
Most of the time the patient's return to the office one week later feeling much improved and wanting to know why this policy was not performed on them earlier and why the policy works. We believe that this technique is prosperous because the abnormal part of the disc that is creating internal pressure against the annulus and nerve root is removed, the fissures in the annulus that allow leakage of disc fluid and material are sealed and tighten up and the constant flow of irrigating saline through the endoscope washes out the irritating damaged metabolites( prostaglandins, histamines,and substance P & X). No deep tissue is cut and commonly no bone has to be removed.
The following patients are not candidates for selective endoscopic discectomy:
1. The rare sick person than has a disk that has become a fully extruded and migrated up into the spinal canal.
2. The sick person has total spinal stenosis will need an total amount of bone removed which is best done with open surgery.
3. The sick person has total spinal instability and requires a spinal fusion that must be done with an open procedure.
For those patients who are afraid of having total spinal surgical operation and have been told that they will have to live with their lower back pain, Selective Endoscopic Discectomy is an provocative prosperous minimally invasive surgical alternative policy that it is performed under local anesthesia and has a very high rate of sick person satisfaction. For further data see www.back-surgery-online.com.
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