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How Successful Is Endoscopic Microdiscectomy?


7.24 - What Is the Success Rate of Endoscopic Microdiscectomy

When it comes to finding relief from the debilitating pain caused by spinal disc herniation, many patients seek effective treatments that are minimally invasive and offer quick recovery. One such groundbreaking procedure is endoscopic microdiscectomy, a surgical technique that has revolutionized the field of spinal surgery. This article discusses the success rate of endoscopic microdiscectomy, shedding light on its benefits and providing insights for individuals exploring treatment options for herniated discs.

What Is Endoscopic Microdiscectomy?

Endoscopic microdiscectomy is a type of spine surgery that involves removing small fragments of disc, bone, or ligament that are compressing a nerve root in the spine. Unlike traditional open discectomy or microdiscectomy surgery, endoscopic microdiscectomy requires only a small incision (about 1/4 inch) and uses a tiny camera (endoscope) and microscopic instruments to access and treat the affected area.

The endoscope allows the surgeon to see the herniated disc and the nerve root clearly on a monitor and perform the surgery with precision and accuracy. The surgeon also uses a laser to seal any tears in the disc and to ablate (destroy) any nerves that are growing in the tear and causing pain. By preserving the disc structure and avoiding muscle dissection and bone removal, endoscopic microdiscectomy minimizes tissue damage, blood loss, scarring, and infection risk.

What Are the Benefits of Endoscopic Microdiscectomy?

Endoscopic microdiscectomy has many advantages over traditional spine surgery, such as:

  • Faster recovery – Most patients can go home the same day they have surgery and resume their normal activities within two to three weeks. Traditional spine surgery may require hospitalization for several days and a longer recovery period of up to six months.
  • Less pain – Endoscopic microdiscectomy causes less postoperative pain and discomfort than open discectomy or microdiscectomy surgery. Patients may only need over-the-counter pain medication or none at all after the procedure. Traditional spine surgery may require stronger pain medication and more frequent follow-up visits.
  • Higher success rate – Endoscopic microdiscectomy has a high success rate of over 80 percent for relieving pain and improving function in patients with herniated discs and other spinal conditions. Traditional spine surgery may have a lower success rate or a higher rate of reherniation or reoperation.
  • Lower complication rate – Endoscopic microdiscectomy has a lower risk of complications, such as infection, bleeding, nerve damage, spinal instability, or failed back surgery syndrome, as opposed to traditional spine surgery. Complications from endoscopic microdiscectomy are rare and usually minor, such as temporary numbness or bruising.

What Are the Risks of Endoscopic Microdiscectomy?

As with any surgery, endoscopic microdiscectomy has some potential risks, such as:

  • Anesthesia reaction – Some patients may have allergic reactions or other adverse effects from the local anesthesia used during the procedure. This may cause nausea, vomiting, drowsiness, or difficulty breathing.
  • Nerve injury – Although rare, there is a possibility of injuring a nerve during the surgery, which may cause weakness, numbness, tingling, or pain in the affected area. This may be temporary or permanent depending on the severity of the injury.
  • Dural tear – A dural tear is a leak of cerebrospinal fluid (CSF) from the protective membrane that covers the spinal cord. This may cause headache, nausea, or infection. A dural tear may heal on its own or require further treatment, such as bed rest, medication, or additional surgery.
  • Disc reherniation – A disc reherniation is when the disc material that was removed during the surgery returns and presses on the nerve root again. This may cause recurrent pain and disability. A disc reherniation may require another surgery or conservative treatment such as physical therapy or injections.

Who Is a Good Candidate for Endoscopic Microdiscectomy?

Endoscopic microdiscectomy is not suitable for everyone with a herniated disc or other spinal conditions. The best candidates for this procedure are those who:

  • Have tried conservative treatment such as physical therapy, medication, or injections for at least 6 to 12 weeks without relief
  • Have moderate to severe pain that radiates from the lower back to one or both legs (sciatica)
  • Have neurological symptoms such as weakness, numbness, or tingling in one or both legs
  • Have a single-level or two-level herniated disc that is clearly visible on an MRI
  • Have no significant spinal instability, deformity, infection, tumor, or fracture

To determine if you are a good candidate for endoscopic microdiscectomy, you should consult with your doctor and undergo a complete evaluation of your medical history, a physical examination, and imaging tests. Your doctor will explain the benefits and risks of the procedure and help you make an informed decision.

What Factors Can Affect Success Rates? 

While endoscopic microdiscectomy boasts a high success rate, certain factors can impact individual outcomes. These include the severity of the disc problem, the patient's overall health, the surgeon's expertise, and the presence of any additional spinal conditions. 

Patients with more severe disc herniation or advanced degenerative disc disease may have slightly lower success rates compared to those with less severe conditions. Additionally, underlying health issues, such as obesity or smoking, can affect the healing process and overall outcomes. It is crucial to have a thorough evaluation by a qualified healthcare professional to assess the suitability of endoscopic microdiscectomy for an individual's specific case.

Although microdiscectomy surgery is generally a very successful procedure, a hole is left in the outer wall of the disc. Patients with a large hole in the outer ring of the disc are more than twice as likely to reherniate after surgery. A new treatment, Barricaid, which is a bone-anchored device proven to reduce reherniations, was specifically designed to close the large hole often left in the spinal disc after microdiscectomy. In a large-scale study, 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in the 2-year study timeframe. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 


If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us at 844-288-7474.

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