Endoscopic Spine Surgery

What is endoscopic lumbar discectomy (spine surgery)?

Endoscopic lumbar discectomy is the smallest and least traumatic spine surgery procedure to remove a portion of a herniated lumbar disc.

How is it done?

The surgeon makes a small incision at the back or side of the patient and inserts a Richard Wolf endoscope (invented by Dr Sebastian Ruetten) into the patient's spinal canal. The surgeon then inserts other instruments through the endoscope to remove a portion of the herniated disc from the spine. The operation is done under general anesthesia and takes approximately 30 minutes. The patient is able to walk immediately after the operation and is required to stay in the hospital for only 12 to 24 hours.

Why is it done?

It is done to remove a part of the patient's herniated disc which is putting pressure on the nerve roots, causing intractable pain or other severe problems. The procedure is considered when:

• The patient's back and leg pain does not subside after 6-12 weeks of anti-inflammatory medications and/or epidural injections with bed rest and rehabilitation.
• A profound weakness is found in the patient's leg.
• The patient is unable to control his/her bladder or bowels.

Risks and complications

As with any spine surgery, there are risks, including the possibility of:

• Complications associated with anesthesia, including respiratory or cardiac malfunction. Risk of infection is low because the operating field is irrigated with water throughout the operation.
• Paralysis; i.e., loss of use of the legs, loss of sensation and loss of control of bladder and bowels (less than 1%).
• Temporary numbness or weakness recovered within three to four weeks (5%).
• Recurrent herniated disc can be expected in 10 to 15% of cases (compared to 10 to 30% if operated using other procedures). This recurrence may require a repeat procedure.
• Back surgery risks can be reduced by following the physician's instructions before and after surgery.

Endoscopic lumbar discectomy (spine surgery) at Bumrungrad

The team is led by a neurosurgeon and orthopedic surgeon who were trained by the developer of this technique, Dr Sebastian Ruetten, in Germany. They have performed 30 procedures in Germany and more than 120 in Thailand, with 90% excellent or good results.

Candidate eligibility

The surgeons will make a final determination of each patient’s eligibility for the procedure after an examination of the patient together with MRI and x-ray images. Overseas patients may send their details with MRI and x-ray images for discussion with the surgeons before visits.

Cost

The cost of the surgery starts from 320,000 Thai Baht approximately $11,000AUD

A Global Health Travel patient talks about his endoscopic spine surgery in Thailand:

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