Percutaneous endoscopic lumbar discectomy, also known as PELD, is a spinal surgery technique used by surgeons to remove vertebral discs in the lumbar or lower spine. The technique has been used throughout the world as a minimally invasive spinal surgical procedure. If the vertebrae in the lower back are compressed, they often inhibit nerve signals, resulting in tingling, pain, and back spasms. Five lumbar vertebrae, numbered L-1 to L-5, are large and strong vertebrae found in the lower portion of the spinal column, responsible for our ability to bend, rotate, and lift.

A B-twin is a type of cage or support used in the fusion of vertebral discs in degenerative disc disease processes to help provide a more secure union to structural skeletal bone without causing damage to surrounding tissues. B-twin cages are commonly utilized in minimally invasive fusion procedures to help provide additional stability and support to the lumbar spine.

Who Benefits From PELD Procedures?
Individuals suffering from chronic low back pain and disability may benefit from a PELD procedure. Those whose back pain affects their ability to work, as well as quality of life and mobility are excellent candidates for this minimally invasive surgical procedure. The procedure is often used in the treatment of herniated or bulging discs, degenerative disc disease and nerve root compression conditions such as sciatica.

PELD with B-Twin Procedure Details
The patient receiving percutaneous endoscopic lumbar discectomy is usually placed under general anesthesia or under light sedation, depending on the individual, the condition of the disc, and the surgeon. An endoscopic or laparoscopic surgical procedure offers shorter hospital stays and recovery periods for individuals, as well as reduced care costs. Small incisions (perhaps 3 to 4 of approximately 5 mm in length) are made in the area above and below the affected disc.  Small pieces of bone or bone spurs are removed to create more room for nerves.

After the incisions are made, a probe is inserted into the incision, after which an endoscope is used to help the surgeon visualize the disc space. The laparoscopic is a long, thin tube equipped with a camera at one and that enables the surgeon to view the surgical field on a monitor or screen in the operating room. This instrument is inserted along with specialized operating instruments and probes that require minimal movement by the surgeon to anchor, repair, or remove a specific piece of tissue, bone spur or even entire organs.

When necessary for support and elongation of a repaired disc space, B-twin spinal spacers are inserted on either side of the disc, hence the term "twin". These spacers are expandable and may be placed through an open or endoscopic surgical approach when necessary to enhance disc space height and stability. B-Twin spinal spacers are often utilized in individuals with degenerative disc disease for increased spinal structural support.

How Much Does PELD with B-Twin Cost?
In the United States, percutaneous endoscopic lumbar discectomy with B-twin cage support may cost about $11,000, but costs may rise depending on geographical location, approach, and the severity of disk damage.  Costs may also rise depending on diagnostics, imaging, medications, or therapies involved in treatment. Patients traveling to foreign destinations such as India, South Korea, or South Africa may save thousands of dollars on the same procedure.

Who Performs PELD with B-Twin Procedures?
A PELD procedure is generally performed by an orthopedic surgeon specializing in spine care or neurosurgeon as well as a vascular or general surgeon. Surgeons should be chosen according to their expertise and experience in related fields. Physicians and surgeons should be certified in their field, and show membership in national or regional boards or associations in his or her country of origin.