When a herniated disc in the lower back has not responded to injections and conservative care, and leg pain, numbness, or weakness is affecting daily life, the next step doesn’t have to be traditional open back surgery. Endoscopic lumbar discectomy offers a more precise, less disruptive path to the same outcome: removing the disc fragment that is pressing on the nerve.
Dr. Todd Koppel performs endoscopic lumbar discectomy as part of his minimally invasive spine care in New Jersey. The procedure is done on an outpatient basis; most patients go home the same day, and recovery is measured in days rather than months.
How Endoscopic Discectomy Works
Traditional open discectomy requires a significant incision and cutting or retraction of the paraspinal muscles, the source of much of the post-operative pain and prolonged recovery.
Endoscopic discectomy achieves the same outcome through a tube approximately 8 millimeters in diameter, about the size of a large pen. This tube passes through a small skin incision and through the natural tissue planes between the muscles, rather than through them. A small camera at the tip gives Dr. Koppel a direct, magnified view of the herniated disc and the compressed nerve throughout the procedure.
He removes the herniated disc material that’s pressing on the nerve. The nerve is decompressed. The tube is removed. The small incision is closed. No muscles are cut or significantly disrupted.
Conditions Treated
- Sciatica from a disc herniation; shooting pain, numbness, or weakness traveling down the leg
- Nerve root compression confirmed on MRI that correlates with the patient’s symptoms
- Significant functional limitation not responding to non-surgical treatment
Endoscopic vs. Percutaneous Discectomy: What Is the Difference?
Dr. Koppel offers both approaches:
- Percutaneous disc decompression: best for contained herniations where the outer disc wall is intact, and disc volume can be reduced without direct visualization
- Endoscopic discectomy: preferred for larger or extruded herniations where the disc fragment needs to be directly removed under camera guidance
Dr. Koppel will recommend the approach that best matches what your imaging shows and what your symptoms indicate.
Percutaneous disc decompression
Recovery
- Most patients go home within a few hours of the procedure
- Soreness at the small incision site is normal for a few days
- Leg pain from the compressed nerve typically begins to improve quickly once the disc material is removed
- Some numbness or weakness may take weeks to months to fully resolve, depending on how long the nerve was compressed
- Light activity is usually possible within a few days
- More demanding activity is gradually reintroduced over the following weeks
Frequently Asked Questions
Precision Is the Difference Between Masking Pain and Actually Stopping It
A joint injection or nerve block placed with expert precision by Dr. Todd Koppel isn’t a temporary patch; it’s a targeted intervention that quiets the exact signals driving your discomfort, giving your body the window it needs to begin healing. Fast-acting. Minimally invasive. Performed right in the office. For patients tired of broad-spectrum medications that dull everything but fix nothing, this is a fundamentally different approach to care.
Pick up the phone and call (973) 473-5752 to find out if you’re a candidate.
