Previously due poor technical support and visualization, surgeons used to take longer incisions to expose a small area. However with magnification tools (loupes, microscopes and endoscopes) and specialized instruments it is now possible to perform a discectomy through a incision less than one inch. This protects the muscles and allow faster out of bed activity.
A fenestration (small tunnel) is made in the bone to approach the nerves and the disc. This does not weaken the spine.
Only the portion of the disc that is herniated is removed. This decompresses the nerve and gives pain relief. The rest of the disc is kept intact. The hole in the disc heals naturally.
The surgery aims to control pain through a keyhole incision. However it does not strengthen or weaken the spine. There is a chance of recurrence if an uncontrolled activity tears the disc. Increasing core muscle strength by exercise is the best protection against a recurrence.
This is safe and effective surgery that allows immediate restoration of activity. The chances of nerve injury are minimized by use of a microscope. The complication rate can be placed at 1% or less.
In certain cases, the disc that is left behind is incapable of taking normal loads resulting in dynamic instability. In such cases the segment is stabilized using an implant (screw-rod construct). This can be done by minimally invasive approach.
Disc surgery does not refrain a person from pursuing a normal lifestyle. However like any other machine, the spine also needs maintenance. For any machine to function optimally the load on the machine (body-weight) should reduce and it should be serviced (core strengthening exercises) regularly.
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