event 12.07.2013.

Our team at Aksis Special Hospital has completely abandoned microdiscectomy as a surgical procedure.

With microdiscectomy, since the disc is left largely empty within (partly because of the preoperative prolapse of nucleus material, and partly because the surgeon must take away any material likely to prolapse postoperatively) a discectomised disc tends to deflate (that is, lose vertical height) rapidly over the next 3-12 months. There are two unpleasant consequences of this rapid deflation, suffered by approximately 30% of discectomised patients: firstly the facet joints behind the disc become increasingly loaded and may cause increasing low back pain; and secondly, deflation of the disc narrows the intervertebral foramen on either side, in which the exiting nerve roots may become compressed. This latter phenomenon is termed “foraminal entrapment”. Many microdiscectomy surgical procedure cases result in FBSS – Failed Back Surgery Syndrome.

Disadvantages of microdiscectomy include, but are not limited to:

  • increased blood loss
  • bigger surgical intraoperative risks
  • longer recovery period
  • higher post-operative pains
  • longer periods off work
  • increased cost for the medical system and your employer
  • much lower quality of life after the surgery.

These are the reasons why our team here in Croatia focuses on minimally invasive spine surgery. For disc herniations, as an alternative to microdiscectomy, we perform:

Selective Endoscopic Discectomy – SED

SED is a method of spinal surgery that announced the beginning of the period of minimally invasive spinal neurosurgery in the nineties of the past century. An American neurosurgeon Parviz Kambin was the first who in 1991 published the results of the treatment he called arthroscopic microdiscectomy. Since then, with the advance of technology and acquiring new knowledge about disc ailments, endoscopic spinal neurosurgery has been rapidly evolving worldwide. Read more about Selective Endoscopic Discectomy – SED.

Percutaneous Laser Disc Decompression – PLDD

Percutaneous laser disc decompression (PLDD) is a type of surgery in which a laser probe is inserted into the intervertebral disc space and laser energy is applied for achieving decompression and neuromodulation thereby relieving the pain. PLDD is a minimally invasive procedure that falls into the category of percutaneous intervertebral surgeries with the aim to significantly reduce the patient’s pain and recover neurological deficit. It is performed under local anesthesia. Read more about Percutaneous Laser Disc Decompression – PLDD.

METRx Microendoscopic Discectomy – Less-invasive spine surgery

The METRx tubular system for spinal surgery is a less invasive version of traditional spine surgery in which tubular retractor is applied by using microsurgical techniques to achieve nerve and spinal cord decompression and spine stability. For the first time invasive surgeries like microdiscectomy, laminotomy, foraminotomy and inner decompression of the spinal cord can be performed in a less invasive way and without the use of general anesthesia. The METRX system combines the reliability of conventional microsurgical methods with the advantages of a minimally invasive technique.

All these procedures are performed by Robert Saftić, MD, on a regular basis. Dr. Saftić is a fellowship-trained and board-certified spinal neurosurgeon. Pioneer of minimally invasive spinal surgery in Croatia and south-eastern Europe. Special interests include minimally invasive spinal surgery with the philosophy of choosing the most effective and least invasive methods. He is an internationally accepted and known expert in the field of laser, endoscopic and microendoscopic spine neurosurgery.