Endoscopic decompression with laser

Endoscopic discectomy and decompression with laser

Endoscopic surgery has proved of value not only for discectomy but also for many other back problems. With this minimally invasive technique all kinds of herniated disks may be removed in a very tissue-preserving way. It may help also with chronic back problems that result from disk protrusions or tears. 

Also more and more spinal stenoses that cause unilateral symptoms may be relieved endoscopically.

A cutting edge laser is used for this surgical intervention. The L.I.S.A. laser works with the so-called sidefire technique and allows for tissue removal at a 90° angle. This greatly eliminates the risk of nerve damaging as opposed to the old “straightforward” technique. 

For more detailed information on the individual topics, please just follow the links.

How is surgery carried out?

Under local anesthesia and x-ray control the narrowed osseous opening through which exit the spinal nerves (foraminal stenosis) is enlarged with special reamers and drills. Already this procedure will help to decompress the pinched nerve. Then an optical endoscope with several minute working channels will be carefully forwarded up to the stenosis. Under sight-control bulging remainders (capsule, ligamentum flavum and bone) are removed at first mechanically with a shaver or shrill and then with the cutting edge L.I.S.A. Laser. The foramen is hence enlarged until the nerve is freed. The L.I.S.A. Laser works with sidefire technique.

This means that tissue can be reached at a 90° angle and by this means the risk of nerve injuries is greatly reduced compared to the old “straightforward” technique.


What postoperative care is necessary?

There will be a follow-up examination the day after the intervention. Additionally a physiotherapist will explain to you an individually targeted rehabilitation program. During the first two weeks you will have to put on a specially fitted plastic corset, which sustains your back and will soon allow for resuming daily activities. It is recommended to start a professionally supervised physiotherapy after one week. After 6 weeks strengthening exercises for your back and abdominal muscles should be started. Simultaneously you might gradually resume your sports activities.

For further reading on the postoperative care after a discectomy you may want to download our brochure “postoperative care”. 

When may I resume my sports activities?

After about three weeks you should be able to go swimming or to ride your bicycle. Your may resume your usual sports activities after 6 weeks.

When can I go back to work?

After one to two weeks you can resume simple office work and slight physical work. You shouldn’t do any hard physical work during the first 6 weeks and then only gradually increase.

All advantages at a glance:
  • The intervention can be carried out under local anesthesia – no general anesthesia is required!
  • As there is almost no tissue damage, the intervention is much less cumbersome and the risk of complications is very low
  • No instability, as the structures that stabilize the spine – the ligaments and joints – remain unhurt. This is a main difference to microscopic surgery technique.
  • Less wound healing pain as well as higher stability, as back muscles are not torn or cut
  • Little infection risk, as access is through a small cutaneous incision (5mm).
  • Less scarring in the region of the nerve roots!
  • Already two hours after the intervention you will be able to walk without pain.
  • Short hospital stay: you can go back home the day after the intervention.
  • Already after a few days you may resume your usual daily activities.
  • Short recovery times: after one or two weeks you can go back to work, after 6 weeks you may resume your usual sports activities.
  • Little scarring