I am Dr. Tony Mork, writer, public speaker, as well as board certified orthopaedic medical specialist devoted to Endoscopic Spine treatment. In 1998, I personally devoted my practice entirely to the endoscopic management of spinal problems and have done more than 8,000 spinal column operations, virtually all with the use of the surgical laser.
Herniated disc surgical procedures are executed for persistent discomfort, weaknesses as well as feeling numb. The discomfort or perhaps weakness should match the actual sensory nerve that is getting pinched as well as compressed by the disc herniation and that’s the reason why an excellent history and assessment is necessary in order to associate these bits of information. At times the disc may be slipped to the side complete opposite of your symptoms. Such things happen occasionally and I usually perform medical procedures on the side of the pain sensation providing the signs and symptoms go with the degree of the disc herniation.
I want to cover a number of areas in herniated disc medical procedures to make note of when considering that. The cut needs to be as small as practical to eliminate the problem. Soft muscle tissues should be upset as little as possible (muscle groups, tendons, structures, arteries, and even nerves) to avoid skin damage that comes about in proportion to the height and width of the incision. I wouldn’t think about a spinal fusion for a slipped disc unless of course it got reherniated over and over.
The next thing to consider is the place of the disc herniation. The positioning can often mean a couple of various things. It could make reference to which section of the spinal column the herniation has happened in (cervical, thoracic, or perhaps lower back) or the place that the disc herniation has occurred (central channel or even foraminal canal). This will make quite a difference because the physiology is so diverse at the various areas of the spinal column (cervical, thoracic, lumbar). As an example, the laminotomy can be routinely performed to take out a lower back disc fragment in the central canal, yet a laminotomy is not used to eliminate a cervical disc fragment within the central canal because the spinal cord wouldn’t accept the pressure associated with retraction that will most likely cause paralysis. A cervical discectomy can be carried out through the front of the neck as soon as the windpipe and esophagus is set aside, but a lumbar discectomy just isn’t performed through the belly as the intestinal tract cannot be correctly pushed aside, let alone the fantastic blood vessels in front of the spine. The thoracic spine possesses its own set of difficulties.
The next matter to think about would be the surgery method (endoscopic, open, “minimally obtrusive”) and whether or not this features a fusion as part of the operation. I just stated before how the purpose of surgery should be to get rid of the offending disc herniation using as little disturbance to encompassing muscle tissues as possible, in particular the spinal nerve root base or spine. There’s ample technique and instrumentation available to avoid a spinal fusion more often than not, even with a cervical disc herniation.
The phrase “minimally invasive” is among the most neglected phrases when found in conjunction with spine surgical treatment, yet not surprisingly so. This expression “minimally invasive” is more of school of thought than a technique, although particular strategies will be more “minimally intrusive”, like endoscopic spine treatment. Nonetheless, the treatment (fusion vs . discectomy) has to be considered at the same time. The philosophy is one that welcomes the very least interference of body tissues that encompass a problem, like a slipped disc. The slipped disc could be the concern, but a majority of body tissues that are entirely normal like muscle tissue, tendons, blood vessels and nerve fibres encompass it. The more “minimally intrusive” the process, the less interference to these encircling regular body tissues, which leads to smaller sized scar problems, less hemorrhaging, less discomfort, and much less trouble for encompassing muscle tissues. Consequently minimally invasive suggests “least collateral harm” when attempting to realize a certain goal such as eliminating a herniated disc.
I usually recommend the endoscopic transforaminal method with an endoscope because it’s directed at the challenge (herniated disc) with the least disturbance to surrounding muscle tissues, through the tiniest possible incision. This approach requires a large amount of training with the endoscope and an advanced three-dimensional capability of the surgeon. We have an endoscope which can be used for the purpose of cervical disc herniations as well.
If this seems like this surgery could be best for your needs, get in touch with my office to plan your free diagnostic session. I can personally study your MRI outcomes and call you to talk about virtually all possibilities for you to cure the discomfort and get back to an active daily life.
Dr. Tony Mork, M.D.
Endoscopic Spine Specialist
Newport Beach, CA & Santa Ana, CA