Intralaminar lumbar microendoscopic discectomy (ILMD)

Intralaminar lumbar microendoscopic discectomy (ILMD) is a minimally invasive surgical procedure used to treat herniated discs in the lumbar (lower back) spine. This technique combines the use of a microscope and endoscopic technology to access and remove the herniated disc material through a small incision in the back. ILMD is designed to reduce tissue damage, minimize postoperative pain, and expedite recovery compared to traditional open surgery.

Here's an overview of how the intralaminar lumbar microendoscopic discectomy procedure works:

  1. Patient Evaluation: Candidates for ILMD are individuals with herniated lumbar discs causing symptoms such as back pain, sciatica (radiating leg pain), numbness, and weakness. Medical history, imaging studies (such as MRI or CT scans), and physical examinations help determine if the patient is a suitable candidate for the procedure.

  2. Anesthesia: The patient is usually placed under general anesthesia, although local anesthesia with sedation might also be used.

  3. Incision: A small incision, typically less than an inch in length, is made in the midline of the lower back, over the area of the herniated disc.

  4. Microscopic Visualization: A microscope is used to magnify the surgical field, allowing the surgeon to see and work within a small space with high precision.

  5. Endoscopic Approach: A specialized endoscope, a thin tube with a camera and light source at its tip, is inserted through the incision and guided to the herniated disc.

  6. Disc Removal: The surgeon uses microsurgical instruments and the endoscope to visualize and remove the herniated disc material that is compressing the spinal nerves. The procedure aims to relieve pressure on the nerves and alleviate associated symptoms.

  7. Closure: Once the disc material is removed, the endoscope is withdrawn, and the incision is closed with sutures or adhesive strips.

Benefits of intralaminar lumbar microendoscopic discectomy include:

  • Minimally Invasive: ILMD requires only a small incision and minimizes damage to surrounding tissues, leading to less postoperative pain and a quicker recovery.

  • Precise Visualization: The microscope and endoscope provide clear visualization of the surgical site, allowing for accurate removal of the herniated disc material.

  • Faster Recovery: Many patients experience a faster return to normal activities compared to traditional open surgery.

  • Reduced Scarring: The small incision results in a smaller scar compared to traditional open surgery.

As with any surgical procedure, there are potential risks and complications associated with ILMD, including infection, nerve injury, and recurrence of disc herniation. The decision to undergo ILMD should be made after thorough evaluation by a qualified spine surgeon, who can determine if the technique is appropriate for the patient's specific condition and individual health factors.

Spine Physicians Institute treats back pain, neck pain, herniated discs, stenosis and other spine problems. Patients come to the spine center from across the Dallas-Fort Worth metroplex. Dr. Sethuraman is one of few Mayo Clinic fellowship-trained spine surgeons in the North Texas area. A fellowship is the highest level of medical education in the U.S.

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