Our surgeons are well-versed in endoscopic techniques to treat lumbar disc herniations with less tissue disruption, faster recovery, and excellent outcomes.
If you have nerve pain that also radiates into one or both of your legs, you are not alone. This is often caused by degenerative disc disease of the lumbar spine, which can lead to a herniated intervertebral disc, a common diagnosis for patients experiencing back problems with resulting nerve pain. For patients with degenerative disc disease that is also causing nerve compression, an endoscopic approach to spine surgery is a procedure that may bring relief and restore mobility.
A herniated disc occurs when an intervertebral disc's soft inner core (nucleus) pushes through a tear in the more rigid outer layer (annulus). This can irritate nearby nerves, causing pain, numbness, and weakness in the lower back and legs[1].
Common symptoms include:
While many herniated discs improve with conservative treatment, some patients may require surgical intervention if symptoms persist.
We offer two primary approaches for endoscopic lumbar discectomy:
Interlaminar Approach
This technique is most commonly used for herniations in the lower lumbar spine (L4/5 or L5/S1 levels). A small incision is made near the midline of the back, and the endoscope is guided through the space between vertebrae (interlaminar window) to access the herniated disc[1].
Transforaminal Approach
This approach is typically used for herniations in the upper lumbar spine. The endoscope is inserted through a small incision on the side of the back and guided through the foramen (the opening where nerve roots exit the spine) to reach the herniated disc.
Understanding Your Spine
The spine is one of the most complex structures in the human body. It consists of bony and soft-tissue structures, including bone, ligaments, tendons, intervertebral discs, muscles, and nerves. When functioning properly, the spine allows multiaxial movement (movement in numerous directions) while providing stability. The primary bone structures to know are the vertebrae, which appear to be “stacked” on top of one another, and the associated parts that keep them together. Between each vertebra are gel-like intervertebral discs that allow for the natural bend of the spine in all directions. Muscles, tendons, and ligaments line the spine from top to bottom. The spine is categorized into four main sections:
The cervical spine, which incorporates the neck region, has seven vertebrae.
The thoracic spine, or mid-back area, has 12 vertebrae
The lumbar spine, or lower back, has five vertebrae
The sacrum consists of 5 vertebrae fused along with the coccyx, or tailbone; this combined structure is a large portion of the pelvis.
Muscles, tendons, and other soft-tissue structures are present in these regions, with many spanning across multiple or all regions of the spine. This guide focuses on the lumbar spine and the endoscopic approaches to addressing a herniated disc. Two vertebrae make up a single level of the spine, with a shock-absorbing disc in between that helps facilitate movements such as rotating and bending. Additionally, nerves serving different areas of the body extend from the spinal cord, which runs through the entire spine and allows neural activity to travel from the brain to the rest of the body. These nerves travel through the foramen, or opening, at the backside of each spine level.
Proven Outcomes Research has shown that endoscopic lumbar discectomy leads to excellent results:
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