Percutaneous Endoscopic Lumbar Discectomy (PELD) - Spine Care/Surgery

Overview
Percutaneous endoscopic topic lumbar discectomy, also known as PELD, is a spinal surgery technique used by surgeons to remove vertebral discs in the lumbar, or lower spine. First introduced in the late 1980s by neurosurgeons at the Free University of Berlin, the technique has been used throughout the world as a minimally invasive spinal surgical procedure.

The spine is made up of 33 segments of bones. These bones are called vertebra, connected by ligaments to each other. The spine protects the spinal cord.  Literally stacked on top of each other, the vertebrae in the spine extend from the base of the skull at the neck, or cervical region to the thoracic section of the spine, or chest area, to the lumbar, or lower back region.

Between each vertebra is found and in vertebral desk, that acts much like a cushion to prevent the vertebral bones from rubbing against one another. They basically act like shock absorbers.  Discs often become damaged through age, carrying heavy weight that causes wear and tear, or injury.

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, responsible for our ability to bend, rotate, and left.

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 procedure. Minimally invasive surgical procedures such as PELD require reduced manipulation of muscle and nerve tissues, specific targeted treatment areas, and result in less blood loss, infection, and healing time.

Per cutaneous endoscopic discectomy surgery is often used to treat:

• Herniated discs
• Bulging disks
• Degenerative disc disease
• Pinched nerve or nerve root compression
• Sciatica

Individuals who undergo a PELD procedure are usually discharged within 24 hours, don't require prolonged periods of bed rest, and can get back to work sooner.

PELD Procedure Basics
An individual receiving percutaneous endoscopic lumbar discectomy may be 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.

A small incision (approximately 5 to 7 mm in length) is 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. The medical definition of percutaneous means "through the skin", and offers a minimally invasive approach to spinal surgery.

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 approach enables the surgeon to make very small incisions through which the laparoscope, 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, 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.

How Much Does Percutaneous Endoscopic Lumbar Discectomy Cost?
In the United States, percutaneous endoscopic lumbar discectomy 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 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.