Day Case Endoscopic Discectomy for a young mother with severe sciatica

This young mother developed back problems in pregnancy which worsened with the demands of motherhood culminating in the onset of intense, severe disabling sciatica due to a slipped disc. She presented within 2 weeks disabled by severe pain. MRI scan confirmed a large slipped disc a t L5/S1 (figure 1).  Initial treatment with a targeted nerve root steroid (epidural) injection made little impact. She was disabled from looking after her child and the pain could not be controlled.  At this point she would be candidate for conventional open microdiscectomy surgery but, in view of her family demands, she did not want to have to go into hospital, nor to have the time off required to recover from surgery.

She was therefore offered a Transforaminal Endoscopic Discectomy procedure for the removal of slipped disc using the Max More system.  This allows the patient to be treated as a day case recovering at home within a week.

At the procedure a substantial disc nucleus prolapse was removed (figure 2) and her pain was relieved.  It took a little time for the nerve to begin to recover fully but the eventual outcome was excellent and she had the treatment needed, surgery with minimal recovery and disruption to family life.  Since then we have treated 10 cases with 1 failure.

MRI Scan showing a large prolapsed disc fragment

Figure 1.  MRI Scan showing a large prolapsed disc fragment

 

The fragment we removed

Figure 2.  A large L5/S1 disc fragment removed at day case endoscopic discectomy.