What it is
Decompression performed through a working-channel endoscope passed down a tube, with continuous irrigation and a camera providing magnified visualisation. The incision is typically under an inch and the procedure is usually done as a day case.
Who it is for
Contained or extruded disc herniations and focal stenosis in anatomically suitable positions. The indications are narrower than for microdiscectomy or tubular decompression: multi-level disease, significant instability and some foraminal anatomy are better addressed another way.
How it works
Under X-ray guidance, a guide wire and dilators establish a corridor to the target — either through the foramen from the side, or between the laminae from behind. The endoscope is passed down the tube and the fragment or compressing tissue is removed under direct magnified vision with irrigation maintaining clarity.
Recovery
Usually home a few hours after surgery. Early back discomfort is typically less than after open approaches, and many people return to light activity within days and desk work within one to two weeks.
Risks and alternatives
Incomplete decompression, recurrent herniation, dural tear, nerve irritation or injury, infection, and the possibility of converting to an open or tubular approach if access or visualisation is inadequate. Alternatives are microdiscectomy, tubular decompression, or continued non-operative care.