Non Surgical Treatments
Surgical Treatments
Transforaminal Endoscopic Fragmentectomy Discectomy
Transforaminal Endoscopic Discectomy (TFED)
It is a minimally invasive spine surgery technique. It utilizes endoscope to treat herniated, protruded, extruded, or degenerative discs that are a contributing factor to leg and back pain.
The endoscope allows the surgeon to use a “keyhole” incision to access the herniated disc. Probably, Muscle and tissue dilated rather than being cut when accessing the disc. This leads to less tissue destruction, less postoperative pain, quicker recovery times, earlier rehabilitation, and avoidance of general anesthesia.
The excellent visualization via the endoscope permits the surgeon to selectively remove a portion of the herniated nucleus pulposus that is contributing to the patients’ leg and back pain.
Furthermore, Trans-foraminal Endoscopic Discectomy (TFED) is different because it is a visualized endoscopic surgical method (like knee arthroscopy). They designed it to visualize the path-anatomy of the disc, spinal canal, and the adjacent nerves. Above all, We use special hand instruments to remove the herniated disc.
About the Procedure
First of all, Surgery time is approximately 45 minutes per disc. A small ¼ inch incision is made on the back to the side of the spine. An entry point is precisely calculated by fluoroscopic intra-operative measurements.
Also, Sedation and local anesthesia provided. Furthermore, The anesthetic will allow the patient to be comfortable during the procedure. but he will leave enough feeling in the nerves so the patient can actually tell when the nerve stimulated or when pressure takes away from the nerve.
TFED Procedure
First of all, the instrument placement performed under fluoroscopic guidance. A conical probe (obturator) with a side hole for palpating structures and for anesthetizing painful structures use to dilate a path to the disc. After determining that the probe is in the safe triangular zone between the traversing and exiting spinal nerves, the disc is entered either by bluntly fenestrating the annular fibers with the probe or cutting the annulus with a trephine.
If there is an unusual amount of pain with the docking of the blunt probe on the annulus, the surgeon can opt to visualize the outer aspect of the disc before entering the disc. Anomalous nerves and branches of spinal and autonomic nerves have visualized and documented as contributing causes of back and leg pain that are currently not recognized by traditional surgeons.
The procedure proceeds by a cannula being passed over the blunt obturator. Consequently followed by insertion of the endoscope and operating instruments. The two spinal nerves protected by the cannula and only the part of the disc needs surgery. And also it will expose to the operating instruments.
The endoscope inserted into the cannula and degenerated nucleus pulposus visualize. And also selectively removed from the herniation site in the posterior portion of the disc. When treating annular tears a small amount of nuclear tissue removed from underneath the tear. Often, some of these nuclear tissue seen interposed within the tear preventing it from healing.
We perform the procedure in a daycare setting. Hence we discharge patients the same or next day.
