What is a herniated disc and when is it serious?
The gel-like core of the disc bulges out and presses on the nerve root; pain radiating from the back to the leg, numbness and tingling are typical. Loss of bladder/bowel control or progressive weakness requires urgent evaluation.
Conservative treatment comes first
In international practice the first step is conservative treatment: medication, activity modification, physiotherapy and, where needed, interventional pain procedures. Surgery is typically considered when symptoms persist after about 3 months of conservative care; in patients who need to return to work quickly, timing is assessed individually.
How is endoscopic discectomy performed?
A working cannula is placed through a small skin entry; under the magnified view of the endoscope, the herniated fragment pressing on the nerve is removed. Foraminal and interlaminar approaches and biportal (UBE) techniques aim for results comparable to open surgery with less tissue damage.
Recovery and return to work
In published series, return-to-work rates after endoscopic lumbar discectomy reach 96%; around 80% of light-duty workers return within 1 month and the large majority of patients within 3 months to the same job. Recurrence at the same level can occur at a low rate; heavy physical work, younger age and disc degeneration are associated with recurrence risk.
Who is it not suitable for?
In cases with significant spinal instability, severe accompanying canal stenosis, some recurrent herniations and multilevel disease, alternatives such as microsurgery or fusion may be more appropriate. The decision is individual — based on MR images, examination and the patient's overall condition.