Sciatica or lumbar radicular pain is most commonly caused by herniated disc aka sliped disc. This can be treated with medicines and physiotherapy in early stages. When conventional treatment fails, conventional treatment is spine surgery which is either open decompression (large incision and lot of tissue damage) or various smaller incision (still open) surgeries with little less tissue damage. All these surgeries involves lot of tissue damage and many a times nerves /spinal cord handling, which in turn can cause failed back surgery syndrome.

Endoscopic spine procedures involves the use of a very small tube like instrument called an endoscope to remove the herniated, protruded, extruded, or degenerative discs and cure the sciatica with much lesser tissue handling and damage compared to open surgery.

Salient features About the Procedure -

• You will be explained about the procedure in detail. The procedure is done under local anaesthesia with or without sedation.
• During the surgery you will be lying on your stomach comfortably. 
• You will be fully awake or if you request mild sedation will be given. 
• The live x-ray (fluoroscope) is used to identify the level where the disc is prolapsed.
• The surgeon will give a local anaesthesia at the site of needle entry. This will make you pain free for the procedure.
• A tiny "Keyhole" incision is made.
• Under live fluoroscopy an endoscope is inserted.
• There is no cutting of muscles, ligaments and Bones is involved.
• With use of specialised equipments like Laser, Radio-frequency, and tiny instruments like disc forceps and annular cutter,  discectomy is performed till free nerves and epidural space is visualised. 
• Once the nerves are free and confirmed on the TV monitor, the endoscope is removed and dressing applied.
• No stitches, wound heals in 4-5 days. 
• Patient is discharged on the same or next day.

Advantages

• Less tissue destruction,
• Less postoperative pain,
• Quicker recovery times,
• Earlier rehabilitation, and
• Avoidance of general anesthesia
• Since patient is fully conscious throughout the procedure, He/she can inform the surgeon about any pain on touching the nerves. This avoids any injury to the nerves and Spinal cord.  

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