What is endoscopic discectomy?
Endoscopic discectomy removes the fragment of a herniated disc that is pressing on a spinal nerve - the usual cause of sciatica or a pinched nerve in the arm or leg. It is done through an opening in the skin smaller than one centimeter, using a small camera (an endoscope) and fine instruments. The aim is narrow and specific: take away only the piece of disc causing trouble, and leave the rest of the disc, the muscle, and the bone as undisturbed as possible.
What happens during the procedure
With live X-ray guidance, the surgeon places a thin tube down to the affected disc and passes the endoscope through it. A magnified view appears on a screen, kept clear by a gentle flow of saline. Working under direct vision, the surgeon removes the herniated fragment and frees the nerve. Many procedures are carried out under local anesthetic with sedation, though some are done under general anesthesia, and it is usually completed as a day case.
Benefits and considerations
The technique offers a small access route for selected herniations. Microdiscectomy or another approach may provide safer or more complete access for other disc positions and anatomical patterns.
It is not right for every case. Large migrated fragments and some anatomical patterns may be better addressed with microdiscectomy or another technique, and a disc can herniate again after any discectomy. Surgery is considered when symptoms, examination and imaging agree and non-surgical care has not been sufficient, or when neurological findings require earlier review.
Recovery and what to expect
Walking is introduced when it is safe. Some cases may be managed as day procedures; others require observation. Pain, numbness and weakness can recover at different rates. Your team will provide a staged plan for wound care, medication, work, driving, lifting and exercise.
If an operation has been recommended, a second opinion can review whether the diagnosis and imaging support the proposed procedure and explain the alternatives.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- A herniated disc is confirmed on MRI and matches your symptoms
- Leg pain (sciatica) is worse than your back pain
- Symptoms persist despite appropriate non-surgical care
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
How soon will my leg pain improve?
The response varies. Leg or arm pain may change before numbness or weakness, which can take longer to recover and may not fully resolve. Your surgeon will explain what the examination and imaging suggest in your case.
How is endoscopic discectomy different from microdiscectomy?
Both aim to remove the disc fragment pressing on the nerve. Endoscopic discectomy uses a camera through a small access point; microdiscectomy uses an operating microscope through a different exposure. The appropriate choice depends on the fragment's size and position, your anatomy and the surgeon's assessment.
Will I be awake during the procedure?
Many endoscopic discectomies are done under local anesthetic with sedation, so you are relaxed and comfortable rather than fully asleep. Some cases are better suited to general anesthesia. Your surgeon and anesthetist will recommend the safest option for you.
How soon can I return to work and drive?
Return to work and driving varies with pain, movement, medication use and the demands of your job. You will receive an individual plan for activity, lifting and follow-up.
Can the disc herniate again?
A disc can herniate again after any discectomy. The likelihood depends on several clinical factors, and your surgeon will explain how this applies to you and what symptoms should prompt review.
Is endoscopic discectomy suitable for every herniated disc?
No. It suits many contained and extruded herniations that match your symptoms, but some large migrated fragments and complex cases are better treated by microdiscectomy or another approach. A review of your MRI and examination tells us whether it is the right fit.