What Is SED?

Selective Endoscopic Discectomy™ or Selective Arthroscopic Discectomy(or Percutaneous Endoscopic Lumbar Discectomy with Laser Thermodiskoplasty) is a new back surgery procedure to shrink and remove a herniated disc thereby alleviating lower back pain and sciatica. Using local anesthesia and the help of flouroscopic x-rays for guidance, specially designed YESS spine endoscope, micro-instruments, the Endius shaver, the Ellman RF and a laser probe are inserted into the herniated disc space. Only the damaged part of the disc is removed with graspers, shavers, and then the annular restraining ring of tissue is shrunk by the very safe Ellman radio frequency probe and/or laser.  Selective Endoscopic Discectomy™ or Selective Arthroscopic Discectomy is different from standard open lumbar disc surgery because there is no cutting muscle or bone removal with this back surgery to resolve back pain and sciatica . There is only one tiny incision to accommodate the micro-instruments inserted into the herniated disc. Most complications that occur with back surgery are eliminated with selective lumbar endoscopic discectomy™.  (Illustration by David Azarello and Christopher Yeung http://www.spineuniverse.com/displayarticle.php/article2221.html)

The Procedure

The back surgery procedure to relieve and sciatica is performed under local anesthesia with the patient awake and in the prone position on special pillows. A small needle is inserted into the disc space after local anesthesia has been administered. A 7mm (1/4 inch) skin incision is made. Over the needle a slightly larger probe is slipped into the disc itself. The YESS spine endoscope is then inserted through a 7mm canula. Under x-ray and fluoroscopic control, the micro-instruments (mini forceps, mini curettes, trephines, rasps, burrs, and mini cutters), Ellman RF, Endius shaver and the laser probe are used for removal of only the damaged disc material. The laser is used for further removal and shrinkage of the disc for the purpose of disc decompression.   The annular ring of tissue around the disc is then treated with a radio frequency electrode used to help control bleeding, shrink the disc tissue or shrink the annulus, and ablate ingrown inflammatory/granulation tissue. Heat from the radio frequency probe may also help depopulate and ablate the pain fibers in the annulus thus relieving the back pain and sciatica.

The back surgery procedure takes about 30 minutes to an hour per disc, on the average. X-ray exposures are minimal. The amount of disc removed and shrinkage by the laser varies, but includes only the herniated and damaged portion. The supporting structure of the disc is not affected. Upon completion of the back surgery, the scope is removed and a small Band-Aid is applied over the tiny incision. See FAQ for more information. (Illustration by David Azarello and Christopher Yeung http://www.spineuniverse.com/displayarticle.php/article2221.html)