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This question was answered on Sun 29, Jun 2008 04:11am by Dr Simran, MD
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Relative success and quality of micr-discectomy and endoscopic discectomy






    
Asked by Unregistered (Female; 31; herniated disk L4-L5, radiating pain in back, right hip, thigh an calf. Numbness in right foot. No significant weakness. This is a recurrence of herniation in same place nearly 2 years ago, which was treated with a cortisone shot. That provided good pain relief eventually, but herniation and pain have reoccureed for last 4 weeks; Relevant drugs:Percocet,ibuprofen ) on Mon 23, Jun 2008 05:37pm :

Is surgery (discectomy) the best option for this patient given the recurrent syndrome. If so what differences do you see between microscopic discectomy and endoscopic disectomy in terms of success and recovery rate?

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Answer by Dr Simran, MD (doctor) on Sun 29, Jun 2008 04:11am:

Hello Dear, The most common problem of a discectomy is that there is a chance that another fragment of disc may herniate and cause similar symptoms. This may lead to recurrent disc herniation, and the risk is about 10-15%.The success of the procedure is about 85-90%. I would recommend you to first go for conservative treatment and keep surgery as the last option. Treatment options are geared toward pain relief. Pain medications such as NSAIDs, corticosteroids orally or injected, anti-spasm drugs, anti-convulsants to help with the pain, and in some cases, narcotic pain relievers are given. You should go in for Physical therapy such as hydrotherapy, massage, and hot,cold therapy. Transcutaneous Electrical Nerve Stimulation is a treatment in which a painless electrical current is sent to specific nerves through electrode patches that are placed on the skin. The mild electrical current generates heat that serves to relieve stiffness, improve mobility, and relieve pain .Neck and back exercises will help you. Treatment methods should be focused on pain relief and maintaining quality of life.Although slow, usually these conservative treatments relieve pain. Regarding the surgical procedures no statistically significant differences were found between microscopic discectomy and endoscopic discectomy,regarding improvement in pain, sensory deficits, motor strength, reflexes, and patient satisfaction. Current data suggest that the microsurgical and endoscopic techniques are superior to the classic technique for the treatment of single level lumbar disc herniations with respect to volume of blood loss, systemic repercussions, and duration of hospital stay. Best
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