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Interlaminar Endoscopic Lumbar Discectomy

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The image illustrates the interlaminar endoscopic lumbar discectomy procedure.
Source: https://media.aofoundation.org/

IELD- An Overview

Interlaminar endoscopic lumbar discectomy is a minimally invasive procedure performed in the interlaminar window, a gap between the spinal bones. During the procedure, our endoscopic spine surgeon use an access port or obturator and an endoscope with a working channel to pass instruments.

Regardless of the nature of the surgery, the key-hole or muscle-sparing technique is used without compromising the primary goals of disc fragment removal and nerve root decompression.

When Do You Need IELD?

At Spine 360, our primary treatment modalities are pain medication and physiotherapy post-diagnosis of your issue. Our spine specialists may recommend IELD only when these treatments fail to deliver the desired outcomes. Early surgery is recommended for the following symptoms:

Foot drop or weakness of the leg
Bowel or bladder disturbance
Advancing numbness
Debilitating pain hampering routine activities
Progressive and recurrent pain after partial improvement
Lack of improvement or progression of symptoms despite conservative therapy.
Pre-Surgical Care For Interlaminar Endoscopic Discectomy
What to Expect During an IELD
Guidelines For Post-Surgical Care

Although it is a minimally invasive surgery, an interlaminar discectomy requires adequate pre-operative measures to ensure your safety and the procedure's success.

  • Consult your doctor for an overall health and fitness checkup prior to your surgery appointment.
  • Inform your doctor of the medications you are following. Your doctor may advise you to refrain from taking blood thinners and other medicines before the surgery.
  • Your specialist at Spine 360 shall review your condition and discuss the details of surgery, including physiotherapy, medications, and other surgeries to remove diseased or fusion discs.
  • Refrain from taking any food or drink after your dinner the night prior to the surgery day. (Typically after 10 pm).
  • You will receive general anaesthesia to ensure the procedure is pain-free and convenient for you.
  • Inclusive of the anaesthesia time (in and out), positioning time (in and out), skin preparation, and procedure, the entire surgery will take a few hours.
  • Once the procedure is complete, your doctor will help you recover from the anaesthetic effect.
  • You will be wheeled to the recovery room and kept under observation for an hour, after which you will be shifted to the ward.
  • You might experience post-operative pain. Our doctors will prescribe adequate analgesics for that.
  • Our goal is to mobilise you and get you back on your feet the same day. Our physiotherapy team shall give you all the guidance and encouragement you need.
  • Any urinary catheters placed during the surgery (for some cases) will be removed once you are mobile.
  • You may experience some stiffness or soreness in the operated site. You may also experience numbness in your legs. However, these side effects will gradually subside.
  • Your post-operative hospital stay depends on your recovery process. However, most patients return home the following day.
  • Our clinical team will dress your wound with a waterproof dressing and guide you on changing it every alternate day.
  • Kindly schedule follow-up appointments after Week 1, Week 6, and six months after your surgery.
  • Make things convenient for yourself at home. Keep your personal items and medications within reach to avoid straining your back.
  • Maintain an organised atmosphere by removing any clutter or furniture that may cause unwanted accidents.
  • Arrange for a family member or friend to provide post-surgical care after your return home.

Understanding Interlaminar Discectomy

Unlike a traditional discectomy, IELD is less invasive because only a 9mm tube is used for the surgery, as opposed to the 40-50 mm incision in conventional microdiscectomy. A smaller tube means a smaller incision and wound to access the spinal cord, thereby promoting an easier recovery with minimum damage to tissues.

Generally, IELD is a safe and minimally invasive procedure. However, as with any surgery, the procedure is prone to risks such as:

  • Infection
  • Allergic reaction to anaesthesia
  • Excessive bleeding
Generally, the procedure lasts sixty to ninety minutes, depending on how many levels are operated on. You will require two to four hours post-surgical recovery time, after which you may return home.
A happy doctor with a stethoscope.

Longing to Get Back to Your Routine Life?

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