What Is Closed Surgery / “Bloodless Surgery”?
Question: Is closed surgery truly “bloodless”?
Answer: “Bloodless” is a lay term. Medically, it includes methods such as endoscopic discectomy, nucleoplasty, laser, or hydrodiskectomy. No large skin incision is made; needle-like entry points are generally used.
Question: Is it suitable for every herniation?
Answer: No. These methods are applied in selected patient groups. The type and location of the herniation and the degree of nerve compression are decisive.
What is known in the literature?
- In series with appropriate patient selection, complication rates are reported in the 1–5% range
- Same-day discharge and early mobilization may be possible
- Some procedures can be performed under local anesthesia or sedation
How is suitability for closed methods evaluated?
- Detailed MRI examination
- Clinical–imaging correlation
- Absence of nerve damage or instability