Endoscopic Spine Surgery

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Endoscopic Spine Surgery: A Minimally Invasive Approach

Endoscopic spine surgery, a form of minimally invasive spine surgery, utilizes advanced technology and techniques in modern surgical procedures. The primary objective is to minimize damage to tissues, particularly muscles, and achieve treatment outcomes comparable to conventional open surgeries.

The use of endoscopy is considered the gold standard for certain types of surgeries, such as knee and shoulder procedures. Over time, endoscopic spine surgery has seen continuous development and is becoming a widely adopted option in some regions.

The key principle involves performing surgery through an endoscope, a tool with a diameter smaller than 1 centimeter, using a single portal and aided by a water system for optimal visibility (lens optic under fluid). This approach reduces blood loss during surgery, as the surgeon views the procedure on a monitor.

Advantages of endoscopic spine surgery include:

• Working under excellent visual conditions.
• Minimized resection of bone and ligaments, potentially reducing surgery-induced instabilities.
• Small incisions (approximately 1 centimeter), leading to less pain and shorter hospitalization.
• Reduced epidural scarring, making future surgeries less challenging.
• Reduced surgery time, especially in cases where expertise is present.
• Indications for endoscopic spine surgery include lumbar disc herniation and spinal canal stenosis, particularly in patients with clear symptoms affecting one side of the body. Other indications are facet cysts and various types of nerve compression.

Postoperative care involves one to two nights of hospital stay, immediate ambulation, and, if necessary, the use of lumbar support for about four weeks. Patients can typically return to work within 2 to 4 weeks, depending on the nature of their work.

While complications similar to traditional open surgeries may occur, the risks are generally lower. Infections, wound issues, and the need to switch to open surgery are potential complications. Recurrent disc herniation occurs in approximately 6% of cases.

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