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Ruptured L4-L5 disk, Open Diskectomy Alternatives?
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Ruptured L4-L5 disk, Open Diskectomy Alternatives?


  I have a ruptured disk at L4-L5.  Two years ago an MRI showed it was herneated and a Dr. suggested a microdiskectomy.  I wasn't in intense pain, and rehabilitated myself back to skiing and mountain biking.  Unfortunatly several months ago the pain returned and a new MRI shows a rupture.  OK I'm in pain and ready for surgery.  New doc says diskectomy but he dosen't do microdiskectomy's.  Says there is not a significant difference in trauma associated with the two procedures and that with fragments traditional would be better.  He is well qualified and in town, but since he dosen't do micro's should I get an opinion for someone who does the microscope procedure?  What about endoscopes for this?
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Dear Kevin,
Percutaneous procedures are all the rage these days.  In the instance of lumbar disc disease it is difficult to argue with the success of a formal microdiscectomy.  In the right hands the success rate is very high and it only involves a small 3-4 cm incision.  It also has the added benefit in that the surgeon can physically see what is going on with the nerve roots and be sure there is adequate decompression of the roots.
Most surgeons use either the microscope or glasses with magnifiers in these cases.  Either is adequate for the job.  Speak to your surgeon about these smaller details.
Good luck.






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