Anesthesiology and Reanimation Specialist Prof. Dr. Serbulent Gökhan Beyaz gave important information about the subject. Low back pain is the most common health problem in the world after the common cold. One of the most common causes of low back pain is herniated disc. The structure of the disc deteriorates due to the decrease in water content of the discs that act as a cushion between the two vertebrae due to heavy lifting, excessive weight, sedentary life, stress, smoking, long-term calcification, non-ergonomic office equipment and beds. Herniation of the lumbar spine occurs when the discs that act as cushions herniate backwards.
The vast majority of low back pain is relieved spontaneously or with the use of painkillers, muscle relaxants, massage and physical therapy, which we call conservative treatment. In a study conducted on a large number of patients in England, it was reported that 86% of patients with lumbar hernia had good results with such treatments. In developed countries, open surgeries related to herniated disc (only when urinary and stool incontinence, loss of strength in the feet and legs) are performed less frequently.
In recent years, many methods have been developed for the non-surgical treatment of lumbar hernia and have been put into clinical use. Epiduroscopy is one of these methods. This method is the imaging of the epidural area, that is, the spinal canal. It is the operations performed by seeing the tissues on a television screen, as in laparoscopic surgeries or endoscopic interventions that our people are very familiar with. In the first years, the spinal canal was visualized with epiduroscopy, allowing the visualization of vessels, nerves and hernias in the spinal canal. With the advancement of technology, two-channel epiduroscopes have been produced, allowing the placement of medical instruments on the one hand while placing the camera on the other, making it easier to use both channels. Especially in the last few years, it has been shown that it is safe and successful in the non-surgical treatment of lumbar hernia.
Almost 1934 years have passed since the technique of open surgical removal of hernias was introduced by Mixter and Barr in 100. Barr, who discovered the open surgery technique, said that 80-90% of the disc that causes herniated disc is composed of fluid, so why would there be a need for surgical instruments in the process of removing the herniated disc from the body? he stated. Can we replace the open surgery technique with the SELD technique with Epiduroscopic discectomy? So what is this technique?
General anesthesia is not applied during the epiduroscopic discectomy operation, no scalpel is used on the spine, side effects are almost negligible compared to open surgery, being discharged on the same day, returning to daily activities and work early, and being able to use cars and public transportation vehicles in the first week are very important advantages of the procedure.
If you have low back pain due to herniated disc and it does not go away with conservative treatments, epiduroscopy should be considered in the treatment.