Dr. Samir Pilankar is a leading surgeon in Spine Endoscopic Surgery in Mumbai. Dr Samir Pilankar has tremendous experience in spine surgeons to diagnose & treat spinal disorders.
The difference between Microdiscectomy and Endoscopic discectomy
Microdiscectomy is the procedure of disc excision with the aid of loupe magnification or a surgical microscope through an open yet limited “smaller” incision.
Endoscopic discectomy is performed with the aid of the endoscope and only uses “stab” incisions, enough to allow insertion of narrow instruments. The operation is monitored on video-TV unit. More importantly the endoscopic techniques approach the anatomical structures from without the spinal canal.
Indications for Endoscopic Spine Surgery
Disc Prolapse and Spinal Stenosis
Presently these are the main indications for posterior endoscopic lumbar surgery. Lumbar canal stenosis can be decompressed by either the uniportal or biportal technique. With conventional surgery, the surgical management of the lateral disk is technically difficult. Open procedures require extensive muscle dissection and may have a destabilizing effect on the spinal architecture. Excessive facet resection can complicate about 2% of decompressions for spinal stenosis and cause recurrent leg and back symptoms. With endoscopic discectomy, stripping of the paraspinal musculature and soft tissue trauma are minimized thus causing minimal morbidity and complications. The risks of causing post-operative iatrogenic instability is also low.
Technique of Posterior endoscopic discectomy (Destandau system)
With the patient prone the disc level is localized on image intensifier and the incision taken slightly paramedian. Following this the outer tube with obturator is introduced so that the outer tube rests on the lower half of the lamina & the upper half on the ligamentum flavum. Now the ligamentum flavum is cut & excised cranio-caudally. The medial facet is undercut. The nerve root is identified & retracted with a special nerve root retractor incorporated in the system.
This presents the disc to vision which is now excised with disc forceps. If lumbar canal stenosis is evident on the MRI the undersurface of the spinous process and contralateral lamina can be nibbled at.
Dr Samir Pilankar will help you for Endoscopic Spine Surgery in Mumbai
Informative Video about the arthroscopic surgeries
Spine Surgery (Part 1)
Duration : 16 seconds
Spine Surgery (Part 2)
Duration : 2 mins 41 seconds