Endoscopic spine surgery is one of the breakthroughs of modern medicine that reflects the technological progress, as the operation is carried out effectively and safely through small incisions with minimal complications and less pain under local anesthesia.
It is like a revolution in the world of spine surgery, and it receives great attention by doctors because they know its benefits on patients, such as mild pain, short hospital stay, speed of recovery, and less risk of infections, as well as avoiding vertebral fixation operations, making them safer. During the operation, the surgeon determines the place through which the endoscope will be inserted, which is a device in the form of a cylinder with a diameter of less than 1 cm, at the end of which is a very small lens that allows a clear view of the inside of the patient’s back on the computer screen as it is magnified several times, increasing the accuracy, efficiency and safety of the operation.
This type of operation is often done from the side of the spine and not from the back, and from an opening of about half a centimeter, it is performed under local anesthesia. In addition to some medications that the patient takes intravenously, the patient can walk and leave the hospital on the same day.
Endoscopic spine surgery allows the successful treatment of many cases, and one of which is when the cartilage is pressing on the nerves, or when the patient suffers from a narrowing in the nerve cavity or as it is known as the bone pressure on the nerves. These operations are performed with minimally invasive spine surgery, which led to a change in the prevailing perception of risks and complications that may occur during or after spine surgeries, such as paralysis, excruciating pain, or a large wound.
Through small incisions that do not exceed one or two centimeters, disc operations, spinal canal expansion (laminaplasty) and spinal fibrosis operations can be performed, in addition to operations to remove spinal tumors or back pain resulting from spinal stenosis.
Endoscopic spine surgeries are mostly performed under local anesthesia, which means that the patient can leave the hospital on the same day with minimal complications, unlike large traditional surgery that requires a longer hospital stay, as well as the risk of wound infection and bleeding, especially if the patient is an elderly or suffers from chronic diseases.
It is one of the modern surgeries that orthopedic surgeons resort to in 70% of cases. Under anesthesia, a small metal tube is inserted to the spine for direct visualization. This tube serves as a passage for the surgical tools so that the patient’s muscles do not have to be torn or cut. Then, the annular tear, bulging disc, or herniated disc can be found easily under direct visualization looking through the tube.
Under the guidance of the x-ray fluoroscopy and direct visualization, a piece of the herniated disc is pulled out with a grasper. A small disc bulge or annular tear can be treated with a laser, which vaporizes disc material, kills pain nerves inside the disc, and hardens the disc to prevent further leakage of disc material to the surrounding nerves. Finally, the tube is removed and the incision is closed with a stitch or two.
Endoscopic Discectomy is a true minimally invasive spine surgery that include the following advantages: minimally invasive, short recovery, high success rate, preservation of spinal mobility, local anesthesia, minimal blood loss, same-day surgery with no hospitalization (outpatient procedure), small incision and minimal scar tissue formation.
One of the advantages of endoscopic spinal stenosis operations is that it achieves the desired goal, as the spinal canal is effectively expanded while preserving tissues, ligaments and bones without the need to remove these tissues, unlike in traditional surgeries that need to stabilize the vertebrae.
This condition affects people after the age of 50, and is caused by enlargement of tissues and ligaments in addition to calcifications. This type of operation is easily and effectively carried out today through a 1 cm incision, and the patient is usually able to leave the hospital on the same day. These operations have lower inflammation rates and higher accuracy, in addition to the easy access of the endoscope to all areas and from both sides.
Recurrent Disc Herniation
Recurrent disc herniation is the return of the disc after 6 months or two years of treatment, and the reason behind this is the removal of the large mass that is pressing on the nerve and not the entire cartilage, which can lead to vertebral erosion and chronic pain. 10% of patients suffer from such condition, which does not mean that the first operation failed, but has achieved what was required, which is to relieve the patient’s pain and preserve most of the disc material necessary for the spine at the same time. Endoscopic surgery in such cases avoids adhesions and fibrosis that can occur around the nerve, which makes the operation easy and safe.
Cervical Neck Surgery
One of the main benefits of the endoscopic cervical neck surgery is to avoid vertebral fixation and placing metal plates, as is known in the cervical neck operations. The operation is carried out through a small incision that does not exceed half a centimeter from the back.
As with the rest of endoscopic surgeries, it is performed with a high safety rate and effectiveness, as the patient can be discharged from hospital on the same day. It should be noted that not all cases of cervical discs are possible with this technique, but the surgeon determines this according to patient’s condition.