Full Endoscopic Spinal Discectomy - Spine Hospital DRHC Dubai
Full endoscopic discectomy FED is the latest trend of minimally invasive spinal surgery using an endoscope to see the neural structures and disc prolapse, enabling adequate and safe removal of the disc fragments, it should be differentiated from the (non-endoscopic) percutaneous discectomy which is done under C arm radiology guidance and associated with a higher risk of failure and complications.
With a full endoscopic discectomy, there is a success rate exceeding 90% compared to a 40-50 % success rate with the (non-endoscopic) percutaneous technique. The complication rate in the full endoscopic discectomy technique is less than 2% due to the elite visualization and instrumentation allowing perfection in the removal of fragments and decompression of the neural elements.
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Full endoscopic discectomy can be done via either the traditional transforaminal approach or via the recently developed inter-laminar approach, which offers additional benefits to access the spinal canal structures for a better rate of success and much less risk of nerve root trauma. I personally greatly prefer the inter-laminar approach in most cases; however, the transforaminal approach can offer some advantages in some cases.
The procedure is done via a 5 mm incision, the guide will be inserted under x-ray guidance onto the inter-laminar space and the scope then follow the space, the anatomical structure will be identified and cleared using the radiofrequency device to stop the little bleeding and clear the soft tissue covering the space, then further access is developed through the yellow ligament to enter the spinal canal safely, the neural elements will be directly visualized and protected before the loose disc fragment is removed under direct vision, followed by inspection of neural elements being free from any pressure, and hereby the procedure is done via less than 1 cm incision.
Previous techniques using the scope via the large dilator are not considered full endoscopic discectomy and carry the same dissection as the usual microdiscectomy procedure.
Another advantage of the full endoscopic techniques is the educational element, as all staff can see the entire procedure on the high-resolution monitor with full illustration, and a copy of the surgery will also be recorded for further purposes.
We at Dr. Rami Hamed Center are proud to provide the full setup for elite full endoscopic discectomy in Dubai, with superior results and outcomes. Dr. Rami Hamed is a well-known spinal surgeon in Dubai with more than 4000 spinal operations on his record.
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