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Endoscopic Discectomy of Rostrally and Caudally Migrated Lumbar Disc Herniations; A Technique Video – Lumbar Fusion

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The article discusses the surgical treatment of extremely migrated caudal and rostral lumbar disc herniations, which can be challenging. The traditional open technique often requires more bone resection, leading to rare but significant complications. However, endoscopic discectomy is a safe alternative with acceptable complication rates. It offers excellent visualization and maneuverability while minimizing soft tissue trauma and bony resection, resulting in less postoperative pain, opioid consumption, and quicker recovery. The article provides a surgical technique guide for endoscopic discectomy and presents two patient cases with high-grade lumbar disc herniations. The risks, benefits, and alternatives to surgery were discussed, and the patients consented to the procedure. The article emphasizes that the video should not replace hands-on training

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated treatment facility on Harley Street UK

Published article

Surgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative to traditional open surgery with acceptable complication rates.^(1-4) Endoscopic discectomy provides the advantage of excellent visualization and maneuverability…

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World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.ABSTRACTSurgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative,

World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.

ABSTRACT

Surgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative to traditional open surgery with acceptable complication rates.1-4 Endoscopic discectomy provides the advantage of excellent visualization and maneuverability while minimizing soft tissue trauma and bony resection which can result in less postoperative pain, opioid consumption, and quicker recovery.5 We present a surgical technique guide for endoscopic discectomy of two patients with very high rostral (grade 1) and caudal (grade 6) lumbar disc herniations as graded by Ahn’s modification of the Lee-Kim grading classification.6,7 Risks, benefits and alternatives to surgery discussed with patients and the patients consented to the procedure. This video is not a replacement to hands on training.

PMID:37625632 | DOI:10.1016/j.wneu.2023.08.074

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Endoscopic Discectomy of Rostrally and Caudally Migrated Lumbar Disc Herniations; A Technique Video

Sciatica My mother was in absolute agony for more than 3 months due to sciatica. It just came out of nowhere and took her out of action. From working full time she went straight to being bed bound and unable to carry out simplest of actions.The pain was 9/10 and she was bed bound for those three months. Multiple trips to A&E and GP and they wouldn't class it as an emergency therefore they wouldn't do anything about it other than upgrading the painkillers which did next to nothing for my mother. I couldn't bear to watch my mother sleeping on A&E bench in pain for 7 hours, just to be told by doctors that she wouldn't be kept in. I remember her joining her hands and begging the doctors to stop the pain which broke my heart. I then started doing research on google and London spine unit came up with Dr Mo AKMAL's profile and review. First meeting with Dr AKMAL was via ZOOM as my mother was bed bound. Dr AKMAL spoke to me and my mom and told us that this is nothing to worry about and that the pain would be 100% gone.Dr AKMAL assured us to visit the hospital so he could physically inspect my mother and give us the best solution. One trip to the london spine unit and Dr AKMAL advised us that the best solution would be to carry out Minimally invasive disectomy. Dr AKMAL advised that due to my mother being bed bound for a while, steroid injection might not give the result that my mother wishes. Dr AKMAL was very confident and showed us some videos from other patients who had gone through the same ordeal. The biggest thing i noticed between before and after was the smile on the patients face. Dr AKMAL was constantly assuring my mother throughout the meeting that he would take care of her pain and gave her 100% confidence that the result would be delivered.He promised her that she would be walking pain free the same day after the operation. Before the operation Dr GURUNG was consulted multiple times and he also was very helpful. Right after the surgery, as Dr AKMAL promised, my mother was walking and the biggest thing was that the pain was gone. My mother had forgotten to smile for three months and there i saw her smiling again. Dr AKMAL and Dr GURUNG gave us brilliant aftercare and informed us that just give them a ring if there was any issue. Its been several weeks now and my mother is heading towards complete recovery without any issues. The pain is completely gone and anyone who is reading this going through the same horrible sciatica pain you must come and see Dr AKMAL. Thank you Dr AKMAL and your whole team for helping my mom achieve this pain free life.

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World Neurosurg. 2023 Aug 23:S1878-8750(23)01187-7. doi: 10.1016/j.wneu.2023.08.074. Online ahead of print.ABSTRACTSurgical treatment of extremely migrated caudal and rostral lumbar disc herniations is technically challenging. Traditional open technique often requires more bone resection which can lead to rare but significant complications such as pars fracture or instability requiring fusion surgery. Endoscopic discectomy is a safe alternative

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