CESS endoscopic disc herniation removal anterior access

The team of the Lower Silesian Center for Minimally Invasive Spine Neurosurgery KCM Clinic in Jelenia Góra specialises in minimally invasive and endoscopic surgical treatment of diseases of the cervical, lumbar and thoracic spine. Until recently, herniated discs in the cervical segment were only surgically treated by traditional methods. However, at KCM Clinic we offer modern treatment with minimally invasive endoscopic surgery to remove a hernia or herniated disc in the cervical spine. Made with precise, minimised in size, endoscopic tools.

The planned effect of the operation

In most patients, this concurrence resolves all or part of the pain in the cervical spine with radiation to the arms, forearms and hands. If before the procedure the patient has neurological deficits, e.g. hand paresis, sensory disturbances, paresthesia and other clinical symptoms, in a large proportion of such patients after this procedure these symptoms disappear either completely or to a significant extent.
The disk (segment) of the cervical spine subjected to this minimally invasive procedure does not lose its cushioning capacity. It still carries the normal loads occurring during the patient’s daily life. Inability to conduct normal daily activities and work usually lasts a few or several days.

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    The fully endoscopic CESS method is intended for the minimally invasive treatment of herniated intervertebral discs in the cervical spine. It uses frontal and contra-lateral access through the disk space. The method of access is aimed directly at the site of the hernia. During the endoscopic visualisation, throughout the procedure, the hernia material pressing on the nerve structures is precisely removed from the inside of the hernia. Such surgical access reduces the risk of damage to the spinal cord.


    Precyzyjne narzędzia endoskopowe wprowadzane są pod kontrolą wizji, dzięki czemu możliwe jest dokładne usunięcie przepukliny z ciała pacjenta. Niewielka średnica endoskopu pozwala na przeprowadzenie operacji w taki sposób aby zminimalizować negatywny wpływa na operowany obszar. Ponadto, w trakcie operacji stosowane są opatentowane urządzenia do radiokoagulacji o niskiej – bezpiecznej dla struktur nerwowych, temperaturze roboczej. Dzięki właściwemu oświetleniu i wysokiej klasy optyce uzyskano wysoką jakość (Full HD) obrazu pola operacyjnego.

    Diseases qualifying for surgery:

    • A protrusion or prolaps of the disc in the cervical spine
    • Narrowing of the intervertebral foramen in the cervical spine (foraminal stenosis)
    • Spinal stenosis in the cervical spine, with or without pressure on the spinal cord, without advanced neurological deficits such as: spinal cord paralysis, lower limb paresis, advanced upper limb paresis.
    • Advanced degenerative changes of the vertebral bodies in the cervical spine
    • Other conditions of the cervical spine, consulted by the patient with dr hab. Stanisław Kwiek

    Before surgery, it is necessary to have a consultation with a neurosurgeon performing the procedure – dr hab. Stanisław Kwiek. To qualify for the procedure, a current MRI or CT scan result is required – the result cannot be older than 6 months. The test results should be with you during the consultation on the CD – the test description alone is not sufficient.


    Magnetic resonance imaging or computed tomography is also available as a private service at OMEGA diagnostic imaging, which receives patients in the same building as KCM Clinic.

    The patient must perform tests in accordance with the recommendations of the neurosurgeon after medical consultation prior to the procedure. Anesthesiological consultation, performed on the day of admission to the hospital ward, is also necessary. Prepare for a two-day stay in the hospital ward at KCM Clinic. Before the procedure, the patient reports to the Registration with full documentation and the results of imaging and laboratory tests.

    It should also be remembered that patients after surgery cannot drive a car. The patient should take care of an accompanying person who will help ensure a safe return home.

    Specialised physiotherapy and rehabilitation are very important after this type of neurosurgery.

    It takes about an hour to recover from the procedure in our outpatient surgical facility and then you can go home. After that, you’ll need to observe how your body responds to the surgery. Most patients feel better right away and can return to work in a couple of days. It’s important to listen to your body and discuss your symptoms with your doctor to ensure you are ready to resume normal activities. Avoid heavy lifting until your doctor gives you permission, even if you feel fine.

    The time of recovery depends on the type of work you do.

    For people who do office work and other kinds of sedentary jobs, the time of recovery is usually one to two weeks. For more active people, like athletes and those who move around more often during their regular workday, the time of recovery maybe four to six weeks.

    During the recovery period, the patient will need to participate actively in a physical therapy program. Physical therapy will help you recover and return to your regular activities faster. Some patients may also be required to take pain relievers during the recovery period. You shouldn’t experience a great deal of pain afterward but may feel a little sore. You don’t even have to worry about stitches; your incision will simply be covered with a band-aid.

    Correct physiotherapeutic management, both before and after our minimally invasive endoscopic procedures, is supervised by Dr. Krzysztof Suszyński – a specialist in physiotherapy.

    People struggling with comorbidities or other health problems must inform the doctor about it during the first qualifying consultation. Before the procedure, perform all examinations as recommended by your doctor and follow all recommendations before and after the procedure.

    About the procedure

    The fully endoscopic CESS method is intended for the minimally invasive treatment of herniated intervertebral discs in the cervical spine. It uses frontal and contra-lateral access through the disk space. The method of access is aimed directly at the site of the hernia. During the endoscopic visualisation, throughout the procedure, the hernia material pressing on the nerve structures is precisely removed from the inside of the hernia. Such surgical access reduces the risk of damage to the spinal cord.


    Precyzyjne narzędzia endoskopowe wprowadzane są pod kontrolą wizji, dzięki czemu możliwe jest dokładne usunięcie przepukliny z ciała pacjenta. Niewielka średnica endoskopu pozwala na przeprowadzenie operacji w taki sposób aby zminimalizować negatywny wpływa na operowany obszar. Ponadto, w trakcie operacji stosowane są opatentowane urządzenia do radiokoagulacji o niskiej – bezpiecznej dla struktur nerwowych, temperaturze roboczej. Dzięki właściwemu oświetleniu i wysokiej klasy optyce uzyskano wysoką jakość (Full HD) obrazu pola operacyjnego.

    Diseases qualifying for surgery:

    • A protrusion or prolaps of the disc in the cervical spine
    • Narrowing of the intervertebral foramen in the cervical spine (foraminal stenosis)
    • Spinal stenosis in the cervical spine, with or without pressure on the spinal cord, without advanced neurological deficits such as: spinal cord paralysis, lower limb paresis, advanced upper limb paresis.
    • Advanced degenerative changes of the vertebral bodies in the cervical spine
    • Other conditions of the cervical spine, consulted by the patient with dr hab. Stanisław Kwiek
    Preparation

    Before surgery, it is necessary to have a consultation with a neurosurgeon performing the procedure – dr hab. Stanisław Kwiek. To qualify for the procedure, a current MRI or CT scan result is required – the result cannot be older than 6 months. The test results should be with you during the consultation on the CD – the test description alone is not sufficient.


    Magnetic resonance imaging or computed tomography is also available as a private service at OMEGA diagnostic imaging, which receives patients in the same building as KCM Clinic.

    The patient must perform tests in accordance with the recommendations of the neurosurgeon after medical consultation prior to the procedure. Anesthesiological consultation, performed on the day of admission to the hospital ward, is also necessary. Prepare for a two-day stay in the hospital ward at KCM Clinic. Before the procedure, the patient reports to the Registration with full documentation and the results of imaging and laboratory tests.

    It should also be remembered that patients after surgery cannot drive a car. The patient should take care of an accompanying person who will help ensure a safe return home.

    Convalescence

    Specialised physiotherapy and rehabilitation are very important after this type of neurosurgery.

    It takes about an hour to recover from the procedure in our outpatient surgical facility and then you can go home. After that, you’ll need to observe how your body responds to the surgery. Most patients feel better right away and can return to work in a couple of days. It’s important to listen to your body and discuss your symptoms with your doctor to ensure you are ready to resume normal activities. Avoid heavy lifting until your doctor gives you permission, even if you feel fine.

    The time of recovery depends on the type of work you do.

    For people who do office work and other kinds of sedentary jobs, the time of recovery is usually one to two weeks. For more active people, like athletes and those who move around more often during their regular workday, the time of recovery maybe four to six weeks.

    During the recovery period, the patient will need to participate actively in a physical therapy program. Physical therapy will help you recover and return to your regular activities faster. Some patients may also be required to take pain relievers during the recovery period. You shouldn’t experience a great deal of pain afterward but may feel a little sore. You don’t even have to worry about stitches; your incision will simply be covered with a band-aid.

    Correct physiotherapeutic management, both before and after our minimally invasive endoscopic procedures, is supervised by Dr. Krzysztof Suszyński – a specialist in physiotherapy.

    Precautions

    People struggling with comorbidities or other health problems must inform the doctor about it during the first qualifying consultation. Before the procedure, perform all examinations as recommended by your doctor and follow all recommendations before and after the procedure.

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