Endoscopic Spine Surgery

What is Endoscopic Spine Surgery?

Endoscopic spine surgery is an ultra-minimally invasive technique in which a camera (called an endoscope) and specialized instruments are inserted through a narrow tube via an incision less than a centimeter in length.  It is typically used to relieve leg pain caused by pinched nerves in the spine.

What happens during endoscopic spine surgery?

During an endoscopic procedure, the spine surgeon makes a small incision through which a thin wire is inserted. Under x-ray guidance, the wire is carefully advanced to the portion of the spine that is causing pain.  Next, the surgeon places several dilating tubes over the wire to temporarily spread the tissues apart.  A hollow tubular retractor approximately the diameter of a pencil is then inserted over the dilators and wire, which are then removed.  

A small camera with a built-in light source is placed through the tubular retractor.  The spine and other tissues are viewed by the surgeon on a high-definition display monitor.  Surgical instruments, simultaneously placed through the same tube, can then be used to remove any pressure from the affected nerve(s).  This may involve resection of herniated disc material and/or bone spurs.  By the end of the procedure, all sources of nerve compression are eliminated.  The camera, instruments, and tubular retractor are then removed, and the muscles and other soft tissues return to their normal positions.  A single stitch beneath the skin and a small bandage is all that is needed over the site of the surgery.

Who is a candidate for endoscopic spine surgery?

Endoscopic spine surgery is effective for spine conditions that cause leg pain, numbness, tingling, weakness, and heaviness.  While back pain may be improved, such surgeries are best suited for patients with significant symptoms in one or both legs.  Typical conditions include: 

Herniated discs

Spinal stenosis

Bone spurs

Facet joint disease

Is endoscopic spine surgery different than minimally invasive surgery?

Minimally-invasive spine surgery represents a spectrum of techniques with endoscopy being the least invasive of all.  It offers numerous advantages over traditional spine surgery, which typically involves large incisions, muscle damage, increased blood loss, general anesthesia, lengthy hospital stays, and prolonged recover.  

What are the benefits of endoscopic surgery?

Endoscopic spine surgery offers many benefits:

Outpatient procedure

Shorter recovery time and quicker return to daily activities, including work and play

Small incision (≤ 1 centimeter)

Less postoperative pain and pain medications

Local anesthesia with sedation, rather than general anesthesia, may be used

Minimal blood loss during surgery

Reduced risk of infection

Avoid fusion in certain circumstances in which it would be otherwise be necessary

What should I expect during/after surgery?

Endoscopic surgery is often performed using local anesthesia and sedation.  Such patients are in a comfortable “twilight” state during the procedure but do not typically recall the details of surgery afterward.  The entire procedure can take as little as an hour.  Patients are up and walking around shortly thereafter and are discharged home the same day.

What are the risks of spine surgery? Is the surgery safe?

While spine surgery can produce excellent outcomes, there are risk to any procedure.  Potential complications include surgical site infection, spinal fluid leak, and nerve damage (which can result in numbness, tingling, pain or weakness).  There are also general medical and anesthesia risks such as heart problems and blood clots.  On rare occasions, during an endoscopic procedure, the planned surgical goals cannot be adequately met.  This may require conversion to another minimally invasive technique or potentially a second trip to the operation room.

What are the physician’s credentials?

All spine surgeons at Texas Health Center for Diagnostics & Surgery are board-certified or board-eligible in orthopedic surgery, or neurosurgery and have undergone fellowship-training specifically in the field of spine surgery.  Surgeons performing endoscopic spine procedures have also performed additional specialized training on these techniques.

How do I make an appointment?

Call our patient navigator at (972) 543-1250, Monday through Friday, 8:00 a.m. to 5:00 p.m. (Central Standard Time) or make an appointment by emailing marketing@thcds.com.