Top endoscopic spine surgeon Dr. Kaixuan Liu explains the newest remedy
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(HealthNewsDigest.com) – Edison, NJ, December 2010 – At any given time, an estimated 15 percent of Americans suffer from low back pain, the vast majority of which can be traced to what doctors call a herniated or ruptured disc (and the rest of us
know as a slipped disc or pinched nerve). It is a condition in which part of one of the discs in the spine bulges out and irritates the nerves nearby.
The pain from a herniated disc can stay in the back or radiate down one or
both of the legs, a condition known as sciatica or radiculopathy. The vast
majority of disc herniations occur in the lumbar region of the spine, which
includes five discs in the area between the rib cage and the pelvis.
In most cases, a herniated disc will respond to conservative
treatments—anti-inflammatories, physical therapy and exercise—plus stronger
pain medicine, if necessary. But in cases where surgery is required, many
patients now have a more appealing option than the old-fashioned back
operations of the past, which involved general anesthesia, a hospital stay,
plus lengthy (and often painful) rehabilitation.
“Now, according to Kaixuan Liu MD, PhD, a nationally distinguished leader in
endoscopic spine surgery and chief surgeon at Atlantic Spinal Care in
Edison, N.J., in cases of contained herniation, when the disc nucleus has
not broken through the annulus, we can perform a minimally invasive
procedure called an endoscopic laser discectomy, which uses a laser to
repair the disc.”
The Myth of the “slipped disc”
Unfortunately, despite its prevalence, this condition is widely
misunderstood, meaning many patients don’t know much about what is causing
their pain. The discs of the spine contain a spongy material, called the
nucleus, that’s encased in a set of fibrous rings called the annulus.
Everyday activities can create pressure on the discs that cause the nucleus
to press against the annulus, but the body can generally cope with that
pressure without any problems. “The discs are essentially shock absorbers,”
Dr. Liu explains. “They cushion the bones of the spine from the impacts of
regular activities as well as more serious challenges, such as running and
jumping.”
Unfortunately, as we age, the annulus tends to degenerate and weaken, and
the nucleus can begin to press against the annulus and cause it to bulge, or
herniate, outward. Eventually, the nucleus may squeeze completely through
the outer ring of the disc. Lumbar disc herniations are often caused by
general wear and tear (people whose jobs require lots of sitting are
especially vulnerable) that is followed by a sudden, traumatic injury such
as the kind you experience when you lift something heavy while bending at
the waist.
What’s more, the symptoms of herniated discs can vary enormously, Dr. Liu
says. “A patient might feel very mild discomfort in cases where only the
disc itself is affected. But if the disc material is pressing on nerve
roots, you can experience severe and unrelenting pain in your back, buttocks
and legs, plus sensory changes such as numbness, tingling, and muscular
weakness that goes all the way to your toes.”
The New Remedy
An endoscopic discectomy is one of the minimally invasive spine surgical
techniques. If the disc is torn, the tear is easily located with endoscopic
visualization. It has a wide application for spinal disc surgery. The
indications include small disc tears, disc degerations, and all kinds of
disc herniations. Often the pain is caused by a small disc tear, which can
simply treated with endoscopic laser disectomy if patient failed all
conservative treatments including epidural steroid injections. In this
procedure, Dr. Liu explains, the surgeon delivers a few blasts of laser
energy, which vaporizes the damaged disc material, kills the pain nerves
within the disc and hardens the annulus to prevent any future leaking of
disc nucleus. No scalpels necessary, he says.
Patients who would be considered candidates for the procedure have had
chronic low back pain, which may or may not radiate into the legs, that has
persisted for more than eight weeks (and has not responded to conservative
treatments). In these patients, a diagnostic MRI, CT scan or other test will
be used to confirm disc herniation, and a nerve diagnostic test (such as an
EMG) will be used to show nerve root irritation.
The endoscopic discectomy uses a tiny camera, called an endoscope, which is
passed through a small tube that has been inserted into the spine via an
incision that’s less than in an inch long. The patient is lightly sedated
and the area to be operated on is treated with a local anesthetic; the whole
process typically takes less than two hours. It’s a speedy (and simple)
procedure that means less pain, risk of infection or other complications,
and a much shorter recovery time for the patient, as well. In fact, most
people leave the hospital the same day, and are back to their regular
activities in about six weeks.
“Studies have shown that endoscopic lumbar discectomies produce outcomes
similar to standard discectomy surgeries—the vast majority of patients are
pain-free after two years—with faster recovery times and less postoperative
pain,” says Dr. Liu. “And in our practice, we’ve found that patients
experience dramatic relief—and are amazed at how simple and painless the
procedure is.”
About: Kaixuan Liu, M.D., Ph.D., Dr. Liu is a nationally recognized leader
in endoscopic spinal surgery. He has substantial experience in this rapidly
developing field, and he treats disc herniations, spinal stenosis, failed
neck or back surgeries, spondylolisthesis, and many other diseases and
conditions in the cervical, thoracic, and lumbar spine. Dr. Liu is certified
by American Board of Pain Medicine and American Board of Anesthesiology.
After fellowship training in Minimally Invasive Spine Surgery at the
Advanced Orthopedic of South Florida, Dr. Liu founded Atlantic Spinal Care,
LLC, in Edison, New Jersey. www.laser-spine.com
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