In most specialist centres, Minimal Intervention Fenestrectomy is performed when disc degeneration is combined with significant bone overgrowth either from the disc margins or from the facet joint margins. This procedure carries the risk of postoperative scaring, nerve damage and muscular functional disturbance. In these circumstances a percutaneous discectomy or Laser Discectomy alone would be insufficient to alleviate pressure on the nerve root. In these circumstances we would use an Endoscopic Laser Foraminoplasty or Decompression to clear the facet joint and vertebral osteophytes.
Eventually when combined with a disc reconstruction (Bionucleoplasty), the resulting restoration of disc height and function will further alleviate pressure on the nerve by the bulging annulus and the overgrown arthritic facet joints.