01Endoscopic laser discectomy

Recently laser has been widely used in the medical field. A laser has a main quality that it generates heat when it meets moisture. So it is suitable to eliminate the nueleus pulposus inside the spinal disk, which contains more than 85% of moisture.
Since the development of the manufacturing technologies of endoscope, more and more endoscope with tiny calibre are presented. And at last, now we can insert an endoscope into the disk. Thanks to these technological innovations, intervertebral disk is now a briefly cured disease.

What are the pros of Endoscopic laser discectomy?
1) Leaves almost no scars(5mm)
2) Recovery after the operation is fast.
3) Since it leaves no scars at near nerves, after reoperation is not a problem.
4) Very few bleeding.
5) Short hospitalization period(1~2 days)

02Nucleoplasty (Nucleoplasty)

We insert a thin needle that generates a frequency of about 100KHz into the disk. Then decomposes the protein molecules that is composing the disk and removes the protruding disk parts by coagulating the protein molecules. This operation method is safer and simpler than any other previous operation methods.

What are the pros of Nucleoplasty?
1) Since we perform operation at 50 degrees, there are no danger of high temperature use.
2) Needs short time for operation(5~10 minutes)
3) Has mere postoperative pain, which is ideal for day surgery.
4) Able to resume normal activity fastly.

03Sleep Microdiscectomy (Sleep Microdiscectomy)

Yes it is true that there are several common treatments presented to the public, but so far the microsurgery is known for the best prognosis. However in the past, microsurgery was performed after general anesthesia, so it wasn’t adequate for patients with diseases that are affected by anesthesia. Recently Central Hospital has started to perform every microsurgery under spinal anesthesia.

Therefore in this case, anesthesia is not a big problem for patients with general diseases such as the elderly, diabetes, and cardiac patients. Since the patient remains conscious, the patient may be stressed about going through the operation. This being so, we try to provide the patient more comfortable operation by using sleep inducer drugs, making the patient sleep through the operation and remove painful memories about the operation.

What are the pros of Sleep Microdiscectomy?
1) No need of general anesthesia, you’ll regain consciousness right after the surgery.
2) Since there are no memories of the surgery, there’s almost no surgical stress on the patient.
3) Patients are done under spinal anesthesia, so only a mere postoperative pain will occur.
4) Even though the patient couldn’t handle general anesthesia(patients with heart disease, diabetes, kidney disease, asthma etc.), operation could be performed.
5) Only a 1 inch incision is need at the surgery.
6) The patient could walk right after the surgery, and could leave the hospital after 2~3 days.

04Artificial disc prosthesis (Artificial disc prosthesis)

A device that has been developed in 1982, although its operation methods are same as the Anterior interbody fusion, there are slight differences in the patient’s choice and post-surgical outcome. Anterior or Posterior lumbar interbody fusion is a fixation that binds two centrums into one, but this device’s main purpose is to preserve the motility between the centrums(curve, expansion exercise) even after the operation.

That is, to treat the disease with maintaining the disk’s structural function. Indications for surgery includes spinal instability caused by degenerative disk and chronic lumbar pain caused by narrow intervertebral distance after hernia surgery. But patients with severe osteoporosis, lumbar spinal canal, and the elderly are not appropriate for this surgery.

In spite of the favorable post-surgical outcomes, it is difficult for patients to choose because of the limited operation indications and high cost. However, if the surgery gets more common with further development in the future, it is expected to give many advantages to patients.

05360° Spinal fusion

A surgery method known with the highest fixation rate, is performed as a simultaneous operation of posterior lumbar interbody fusion and disc prosthesis. Thanks to the development of the surgical techniques, we now only require about 3 hours of operation time with no need of blood transfusion. With great postoperative recovery, patients could walk right after the operation without any problem, and feel almost no pain except around the surgical site. Necessary hospitalization period are about 1 week, we proceed passage observation without physical therapy and medication for 3 months within a one-month period after hospital discharge.

It is still a controversial issue whether which surgical method a patient should take, also the research materials draw different conclusions too. So after all, the patient has no choice but to rely on the doctor’s surgical method choices. In other words, meeting an experienced physician is very advantageous.

One thing that is certain is that if you’re a patient with severe dislocated adjacent spines and severely narrow intervertebral distance, you should definitely choose this surgical method. Sure you can show temporary symptom improvements with other surgical methods, but when monitored in a long-term, the recur of spinal instability may require revision operation.