19 Harley St, London, W1G 9QJ, UK

Spinal Epiduroscopy Surgery

The Future of Spinal Epiduroscopy Surgery is here now.

Spinal Epiduroscopy Surgery – Epiduroscopy requires the placement of a 2mm flexible steerable endoscope through the sacral hiatus in to the epidural space around the dura.  This technique avoids open surgery and allows direct access of the disc fragment can be removed. The camera can look sideways and laser fibres may be passed down these endoscopes and thus scarring in the epidural space surgery may be mobilised. We are developing a system that can extract the disc fragment completely. This technique is limited in its ability to address intradiscal and foraminal pain sources. However Mr Akmal is exploring methods of addressing these pain sources from this approach.

Towards New Horizons in Spinal Surgery

Spinal Epiduroscopy SurgeryThe goal of Epiduroscopic spinal surgery is to avoid open surgery and allow disc fragments, scar tissue, fibrosis and other inflammatory tissue to be removed internally from the epidural space. There is no muscle retraction and recovery is very fast. Most patients can return to work within 24 hours after surgery.

Percutaneous epidural adhesiolysis and spinal endoscopic adhesiolysis are interventional pain management techniques used to treat patients with refractory low back pain due to epidural scarring. Standard epidural steroid injections are often ineffective, especially in patients with prior back surgery. Adhesions in the epidural space can prevent the flow of medicine to the target area; lysis of these adhesions can improve the delivery of medication to the affected areas, potentially improving the therapeutic efficacy of the injected medications.

As with all minimally invasive spinal surgery techniques, the surgeon requires a considerable amount of experience in this procedure.

There may be awkward occasions where a large amount of disc material has extruded from its enclosure, wrapping itself around the nerves, causing severe inflammation, pain and even nerve damage. Such disc extrusions may be highly resistant to cortisone injections, or because of the nerve damage and severe pain, require immediate relief of pressure on the nerves. Where previously, the only option is an open discectomy/spinal decompression, we can now thread a small camera through a natural opening in the base of the spine directly to disc extrusion within the spinal canal.
Because we are exploiting the body’s natural openings and channels, we do not need to strip off any muscle or bone to access the spinal canal, save a small cut in the skin.
The camera allows us to directly visualise the nerves and disc fragments, and using endoscopic instruments, carefully separate the nerves from the discs. The disc fragments can then be vaporised either by laser or physically extracted.
Again, because it is a percutaneous technique, it can be performed under supervised sedation as a day case. Leading to faster recovery and rehabilitation.

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Spinal Epiduroscopy Surgery

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This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus
Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.

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