The Endoscopic Technique

WHAT IS FULL ENDOSCOPIC SPINE SURGERY?

Full endoscopic spine surgery is an ultra-minimally invasive surgical technique that is used to treat compression of the neural elements from pathologies of the spine such as disc herniations, synovial cyst and stenosis. These surgeries are typically performed under general anesthetic so that you are asleep throughout the procedure.

 

In general, the surgeon makes a small incision at the area of the pathology. Small tubes (dilators) the size of a pen, are used to create a tunnel to the vertebra. An endoscope is then advanced to the site of the pathology which allows for superior visualization of the neural elements and surrounding anatomy. Due to the small size of the endoscope, the surgery can be performed with only minimal amount of bone being removed to gain access to the pathology. In some cases there is no need to remove bone at all. Specialized tools are used through the endoscope to complete the goals of the surgery. Once the surgery is complete, the anesthetic is reversed. The skin around the incision is injected with long-acting numbing medication and you are taken to the recovery room.

Dilator

The view from the endoscope is much clearer than the view from a microscope due to the endoscopes ability to bring the camera directly to the surgical field and providing a wider field of view. In Microscopic surgery, the camera from the microscope is further away from the operative field and its field of view is limited to circumference of a tubular retractor. To re-iterate, due to the small size of the endoscope, less bone is removed and in some cases none, depending on the goal and type of surgery.  

Microscope vs endoscope

WHY IS FULL ENDOSCOPIC SPINE SURGERY NOT STANDARD OF CARE IN THE UNITED STATES? 

In contrast to the rest of the world, very few institutions offer full-endoscopic spine surgery. Learning full-endoscopic surgical technique requires years of training. Moreover, specialized equipment requires additional capital compared to traditional surgery. Lastly, there is currently no incentive by hospitals or payers to encourage surgeons to perform this type of surgery. Members of our group are developing, teaching and validating full-endoscopic spine surgery on a national and worldwide level.

WHAT IS THE RECOVERY LIKE AFTER A FULL ENDOSCOPIC SPINE SURGERY? 

Recovery time after a full endoscopic spine surgery is generally faster than an open spine surgery. The course of recovery, however, for each patient is often dependent on the individual and depends heavily on how well they manage their recovery.