Methods of treatment

Endoscopic intervertebral disc operations

Endoscopic operations are the latest and gentlest operating procedures. Minimally
invasive intervertebral disc surgery belongs to this class of operations. The surgeon
no longer cuts the back open and needs no scalpel or general anaesthesia. Instead,
the surgeon removes the ruptured disc with very fine instruments and special devices
through a millimetre-sized incision, similar to a "keyhole". The TESSYS method® is a
special endoscopic operating method which places only minimal strain on the patient
and prevents wound and muscle pain.

You can see an animation of endoscopic operating technique here.
You'll find further information about the TESSYS method here.

Endoscopic operations through a "keyhole" according to the TESSYS method® – gentle and effective

The advantages compared with micro-surgical or the open intervertebral disc operating technique include:

  • Thanks to our long-standing experience with endoscopic operations, we can perform operations under general anaesthetic. This is advantageous for most of our patients. Following the operation, which lasts around one hour, they wake and e.g. immediately feel their feet, but are not aware of the operation itself. On request, however, we also offer analgo-sedation. Here, the patient is conscious and can communicate during the entire operation. The patient's ability to remember is nevertheless somewhat limited. Experience shows that this anaesthetic method is not well-suited for patients with anxiety.
  • The operation requires only a tiny skin incision measuring around 1 cm, so that the risk of infection during and after the operation is very small.
  • Compared with the micro-surgical operating technique, trans-foraminal access is gentler on the vertebral joints, ligaments and structures, and the risk of instability is minimised.

What are the benefits of this new endoscopic intervertebral disc operating technique for the patient?

The advantages compared with the micro-surgical open intervertebral disc operating technique include:

  • a smaller, almost invisible scar
  • less injury to tissue along the access path to the ruptured disc and less risk of injury to nerves
  • no side effects due to full anaesthetic
  • very short in-patient time – on request, the operation can also be performed on an out-patient basis
  • short recovery time, allowing rapid return to work
  • fewer rehabilitation measures and better quality of life thanks to less pain medication

What is the procedure for the endoscopic intervertebral disc operation?

We perform endoscopic disc operations at the Ligamenta Spine Centre using the TESSYS method. This operating system removes the ruptured disc in a gentle way using an endoscopic access path from the side via the intervertebral foramen – i.e. practically a natural access path. During the operation, the patient is in a stable position, lying on the stomach or the side, and is only placed under local anaesthetic.

After making an access path of around 0.8 mm in diameter using the minimally invasive technique, an instrument sleeve is introduced. The endoscope is then guided using x-rays to the operating site.

The endoscope has a channel through which various fine instruments can be introduced. In order not to injure any nerves, the intervertebral foramen is gently widened, millimetre-by-millimetre, with special tiny milling instruments - and thus slightly enlarging the already existing "door" to the spinal canal. The endoscope is also connected to a camera, providing high-definition images of the progress of the operation on a monitor. The instruments used, such as forceps and grippers, can therefore be manipulated under constant visual guidance. This ensures perfect control for the removal of the worn intervertebral disc tissue.

Fit again in no time, thanks to the state-of-the-art techniques

Out-patient treatment
During the TESSYS® intervertebral disc operation the surgeon removes only the worn disc material and leaves the surrounding tissue undamaged. The stability of the spine therefore remains intact, and the patient can usually leave the hospital on the same day or a few days afterwards.

Smallest possible access path
According to the Cleveland Clinic Foundation research clinic in the USA, a patient undergoing an operation using the endoscopic method no longer suffers any discomfort after three to six weeks. However, with conventional operating techniques, the recovery process lasts three to six months.

The documented success rate with TESSYS®-operated patients is more than 90 per cent. Only between five and six per cent of those undergoing the operation require a second operation. With other methods, the relapse rate is between 10 and 12 per cent.

More information can be found on the TESSYS® operation in the joimax® patient brochure.

Here you will find the information as pdf-file

Methods of treatment

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