The key principle is using MRI images to plan the surgical corridor and target of the problem, usually prolapsed disc fragment pushing against the nerve. Once patient anaesthetised, a guidewire is passed through the muscles using X-ray. Rigid tubes of the diameter of thumb are passed over the guide wire and surgical target visualised in the microscope. After minimal resection of the bone, nerve carefully retracted and disc fragment excised. Adequacy of the space for the nerve confirmed with blunt probe and bleeders controlled using bipolar diathermy.
Advantages in comparison to traditional Lumbar discectomy:
– Preserve the function of Multifidus spinal muscle which is useful to maintain the core muscle balance of the
back and preserve the function of Spinal joints. This avoids stiffness of the back and prevents arthritis in the
facet joints.
– Avoids crush injury of the muscles secondary to using blunt retractors in comparison with traditional discectomy
surgery.
– Snak surgical incisions aids in quicker recovery and early hospital discharge compared to traditional
discectomy.
– Other proven advantages include less blood loss and low rates of infection.
