Lumbar Spine Percutaneous Endoscopic Discectomy medical legal presentations

http://www.medilaw.tv Lumbar Spine Percutaneous Endoscopic Discectomy medical legal presentations. This movie illustrates the technique for performing a percutaneous endoscopic lumbar discectomy. This movie shows patient positioning, skin preparation, local anesthetic injection, cannula insertion, the removal of some nucleus material, herniation retraction, the annuloplasty, instrument removal, and wound dressing.

Sudden trauma or gradual degeneration can weaken the annulus fibrosis or wall of the intervertebral disc. This can then bulge outwards, forming a disc protrusion or a contained disc herniation. The pressure of the bulge against the surrounding structures causes back pain and the pressure against the nerve root causes leg pain.

Percutaneous discectomy is a minimally invasive disc decompression technique which is performed through a needle. The discectomy removes some nucleus material from the intervertebral disc whilst minimizing damage to the adjacent tissues. The removal of nucleus material decreases the pressure within the disc, which can result in the contained disc herniation retracting. This in turn can lead to a decrease in back and leg pain.

The percutaneous approach with a needle uses a small entry hole in the disc and removes a small amount of disc material. These all act to minimize tissue damage due to the procedure. This decreases the pain, complications and recovery time, and maximizes the spine's strength and stability after the procedure.
Lumbar Spine Percutaneous Endoscopic Discectomy medical legal presentations
INDICATIONS
The indications for a percutaneous discectomy are
- back or leg pain, caused by
- a contained disc herniation seen on radiological imaging
- that has not responded to at least three months of conservative treatment including pain relief medication, bed rest, physical therapy and pain relieving injections.

ALTERNATIVES
The non-surgical alternative treatments to percutaneous discectomy may be
- activity modification or bed rest
- strength and flexibility exercises
- physical therapy
- hydrotherapy
- acupuncture
- pain-relieving medications such as acetaminophen or paracetamol, non-steroidal anti-inflammatory drugs

- The surgical alternative treatments to percutaneous discectomy may be
- steroid and local anesthetic injections
- open or minimally-invasive microdiscectomy
- surgical fusion or disc replacement.

GOALS
The goal of a percutaneous discectomy is to cause the disc herniation to retract, which in turn can lead to a decrease in back pain and leg pain.

TECHNIQUE
You will be lying on your front. Your back will be cleaned. A local anesthetic injection will numb the skin. This may sting for a couple of seconds. A cannula will be introduced into the intervertebral disc. Fluoroscopy, an X-Ray TV, is often used to help guide the cannula to the correct location. The device will be advanced from the cannula, and will remove some nucleus pulposus to decrease the pressure within the disc. Then the cannula will be removed. A small bandage will be placed on the skin. Lumbar Spine Percutaneous Endoscopic Discectomy medical legal presentations.

Category:

Education

Tags:

• Lumbar
• Spine
• Percutaneous
• Endoscopic
• Discectomy
• medical
• legal
• presentations

[itic3]

Wow it's amazing what they can do now...