Endoscopic Spine Surgery is a type of spine procedure that employs an array of tubes so surgical tools can be funneled to the site. Spine surgery, with time, has evolved and become more effective and less invasive. The least invasive option available today when it comes to disc surgery is endoscopic spine surgery.
Endoscopic spine surgery involves the use of an endoscope for visualization of the disc. An endoscope has a high definition camera at its tip and is inserted through a 6mm tube. Different instruments can be introduced through the tube to take out the disc material which is protruded or herniated. The patient is under sedation but is arousable or awake, and the procedure is performed under local anesthesia. The patient’s feedback is extremely important and makes the procedure extremely safe. Patients lie face down for the procedure.
Compared to conventional disc surgery, endoscopic discectomy has several advantages. It bypasses the requirement of cutting muscles, bone and ligament to access the disc space and gives direct access through the foramen where the nerve roots exit. The opening in the skin is so small that it does not require any sutures to close. Using local anesthesia helps to avoid problems associated with general anesthesia. Patient feedback determines the endpoint of the procedure. It is absolutely anatomy preserving and no bridges are burnt. Many of the complications of conventional disc surgeries are further reduced. Patients go home the same day and have restrictions for 6 weeks to allow the hole in the disc space to heal. Once it heals, patients can go back to active lifestyle and even sports. The endoscopic approach is mostly suitable for patients with disc disease. Endoscopy can be used for neck as well as for back. The anatomy of the lower back is more favorable for its use. Any patient, who has disc herniation causing pinching of nerve roots, resulting in sciatica like pain in the lower extremity, without any bony narrowing of the spinal canal or arthritis in the lumbar spine can be ideally treated with endoscopic discectomy.
The endoscopic approach is mostly suitable for patients with disc disease. Endoscopy can be used for neck as well as for back. The anatomy of the lower back is more favorable for its use. Any patient, who has disc herniation causing pinching of nerve roots, resulting in sciatica like pain in the lower extremity, without any bony narrowing of the spinal canal or arthritis in the lumbar spine can be ideally treated with endoscopic discectomy.
There is a great deal of future research going on in further application of endoscopic spine surgery. Its use will be further expanded to use it in patients with stenosis and arthritis and also for fusion. The general surgical world has moved away from open surgery to laparoscopic surgery; on similar lines endoscopic techniques are the future of spine surgery.
Dr. Amit Bhandarkar M.B.B.S., M.S., M.D. is a fellowship trained, Orthopedic Spine surgeon. Dr. Bhandarkar evaluates and treats a wide variety of spine ailments consistent with his comprehensive spine training.
He has practiced and done fellowships in the USA, Canada, Seoul (South Korea), Maldives and India. His area of focus is minimally invasive spine surgery, and his special interests are spine related pain management and endoscopic spine surgery (the least invasive option) for lumbar disc related disorders.