Spine Endoscopic Discetomy (SED)
Spine Endoscopic Discectomy (SED) is a minimally invasive spine surgery technique that utilizes an endoscope to treat herniated, protruded, extruded, or degenerative discs that are a contributing factor to leg and back pain. The endoscope allows the surgeon to use a “keyhole” incision to access the herniated disc. Muscle and tissue are dilated rather than being cut when accessing the disc. This leads to less tissue destruction, less postoperative pain, quicker recovery times, earlier rehabilitation, and avoidance of general anesthesia. The excellent visualization via the endoscope permits the surgeon to selectively remove a portion of the herniated nucleus pulposus that is contributing to the patients’ leg and back pain.
Thermal annuloplasty is an adjunctive procedure that uses bipolar electro-thermal energy (radiofrequency and/or laser) to ablate or depopulate the sensitized pain nociceptors in the annulus, ablate any inflammatory/grannualtion tissue that has grown into the annulus, and to shrink and tighten the stretched or torn collagen fibers of the annulus. The annulus is the outer portion of the disc and is composed of many concentric layers that are arranged similarly to the plies of a radial tire. Thus, the weakened annulus or defect left by the disc herniation is contracted and possibly sealed from within the disc.
This combination procedure and the endoscopic system used to perform the unique procedure is pioneered and developed in India by Dr. Satish Chandra Gore. This state of the art technique is an evolution from the technique originally described by Dr. Young and Parviz Kambin called Arthroscopic Microdiscectomy (AMD).
There are other electro-thermal techniques utilized for painful, bulging degenerative discs and annular tears called IDET and Nucleoplasty/Coblation. SED and thermal annuloplasty, however, is NOT the same. SED is different because it is a visualized endoscopic surgical method (like knee arthroscopy) that is designed to visualize the patho-anatomy of the disc, spinal canal, and the adjacent nerves. These other percutaneous procedures are only fluoroscopically guided and are termed “blind” procedures. Consequently, SED can be used for pain caused by contained or non-contained (extruded) disc herniations, and sometimes works as well for discogenic back pain that is not responsive to non-operative treatment.