How TELD Can Relieve Your Lumbar Disc Herniation Pain

A pictorial representation of the transforaminal endoscopic lumbar discectomy procedure.

Source : Midwest Orthopaedics at Rush, LLC

TELD: An Overview

Transforaminal Endoscopic Lumbar Discectomy (TELD) is a percutaneous procedure and a type of endoscopic discectomy. This method is conducted from the flank of the spine, utilising an endoscope to navigate through the natural opening in the spine known as the intervertebral foramen. The surgical process involves the use of an access port (obturator) and an endoscope equipped with a working channel, allowing for the passage of instruments during the surgery. Notably, the diameter of the entire port is a mere 9 mm.

A distinctive feature of percutaneous transforaminal endoscopic discectomy is the preservation of normal structures such as bone or ligaments. Throughout the procedure, a muscle-sparing, keyhole technique is employed in endoscopic surgery, irrespective of the surgical nature. This meticulous approach ensures that the primary objectives, namely nerve root decompression and the removal of disc fragments, remain uncompromised.

Who Will Need Transforaminal Endoscopic Discectomy

Individuals with disc prolapse (disc herniation/slip disc) who are unresponsive to conservative treatments such as pain medication and physiotherapy.

People with spondylodiscitis - an infection of the disc space. Here, endoscopy aids in obtaining a biopsy of disc material to identify the potential source of infection and facilitate nerve decompression.

Early surgical intervention is recommended in case the patient develops the following symptoms:

Weakness in the leg or foot drop

Bladder and bowel disturbance

Progressive numbness

Pain that is debilitating and hinders daily activities or walking

Lack of progression or improvement of symptoms even after conservative therapy

Episodes of recurring pain after partial improvement

Presurgical Care for TELD

What to Expect During the Surgery

Post Surgical Care

Consult your doctor before surgery to assess your fitness levels and overall health.
Inform your doctor about the medications you are taking, and inquire if any should be discontinued before surgery, such as blood thinners.
Your doctor will discuss your condition, presenting various options like physical therapy, medications, or other surgeries, such as disc removal or fusion.
Refrain from eating or drinking anything after 10 pm on the night before the surgery.

The surgery will be performed under General Anesthesia.
The procedure, encompassing anesthesia time, positioning, skin preparation, and the surgery itself, will last a few hours.
Following the surgery, you will be awakened and monitored in the recovery room for one hour before being transferred to the ward.
Adequate analgesics will be administered to manage postoperative pain.
Early mobilization, facilitated by a physiotherapist, is the goal and is typically initiated on the same day.
Urinary catheters, if inserted during surgery in certain cases, will be removed after mobilization.
Some mild soreness, stiffness in the back, or numbness in the leg may be experienced post-surgery, with these side effects gradually subsiding.

Post-operative stays may differ as recovery varies from patient to patient. However, patients typically return home the following day.
A water-proof dressing will be applied to the wound, requiring changing every alternate day (instructions will be provided before discharge).
Regular follow-up appointments are essential at 1 week, 6 weeks, and 6 months post-surgery.
Prepare your home for the post-operative phase by placing essential items like medication and personal hygiene products within easy reach.
Eliminate safety hazards, such as floor clutter, to prevent tripping or balance issues.
Arrange for assistance at home and around the house following the surgery.

Frequently Asked Questions About TELD

1. In what ways is Transforaminal Endoscopic Lumbar Discectomy advantageous?

This approach utilizes natural spinal openings, avoiding disruption to healthy tissues. Unlike traditional minimally invasive surgery, this technique does not involve stripping muscles from bone, removing healthy bone, or cutting important spinal ligaments to access the disc. The use of a needle for disc access eliminates the need for a skin incision, resulting in only a skin nick. With surgery performed through a tiny skin nick and preservation of healthy tissues, the procedure allows for a same-day process and a faster recovery.

2. Is the surgery performed using laser?

The endoscopic surgery is carried out using state-of-the-art instruments. They look like miniaturized versions of the traditional surgical tools and can be elongated to fit through the endoscope. Specialized thermal probes are utilized for ablating diseased tissue under endoscope guidance. While lasers may be used in some cases to remove bone and disc, it's essential to note that despite their prevalence in medical advertising, lasers simply serve as a tool in the surgeon's arsenal. It may or may not be used as per the requirement.

3. How much time will it take to complete the surgery?

The procedure typically lasts an hour to an hour and a half, contingent on the number of levels operated on. After the procedure, there is an approximately two-hour recovery period before returning home.

Reclaim Your Spine Health

Book your Transforaminal Endoscopic Lumbar Discectomy at Spine 360, Bangalore, and step into a pain-free life. Take the first step towards relief.

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Transforaminal Endoscopic Lumbar Discectomy

TELD: An Overview

Who Will Need Transforaminal Endoscopic Discectomy

Frequently Asked Questions About TELD

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