What Is Endoscopic Spine Surgery?
Endoscopic spine surgery is a revolutionary, minimally invasive procedure for spine care. This procedure uses small tools and an endoscope with an angled camera lens to magnify and illuminate your spine. This allows your surgeon to access your spine with minimal to no bone or muscle removal. This technique allows your surgeon to correct your spine problems with smaller incisions (surgical cuts), fewer risks, and quicker recovery.
Open Spine Surgery vs. Minimally Invasive Surgery
Endoscopic spine surgery is different from open spine surgery in several ways:
- Open surgery requires your surgeon to move your muscles out of the way to see your spine. During endoscopic surgery, your surgeon uses an endoscope with a camera at the tip that allows them to see your spine without removing any of your muscles. This technique reduces your risk of muscle injury and trauma during surgery.
- An endoscopic spine surgeon washes out your incision using a continuous flow of IV-fluid during the procedure. This technique keeps circulating air out of your incision to minimize blood loss and infections.
Best Candidates For Endoscopic Spine Surgery
The best candidates for endoscopic spine surgery are those with simple spine problems such as spinal stenosis or a herniated disk. Scoliosis and other more complex spine conditions often require other types of surgery. However, we can treat some complex cases of spinal disease with endoscopic spine surgery on a case-by-case basis.
We will need you to undergo the following imaging tests and exams to ensure that endoscopic spine surgery is the best treatment for you:
- MRI and/or CT scans of your spine
- Spine X-rays that show movement
- A physical exam to ensure you're not at high risk for complications
- Answer detailed questionnaires and complete pain drawings
You may also need to undergo physical therapy and spinal injections before surgery to comply with your health insurance requirements and to reduce risks of unnecessary surgery.
Risks & Benefits of Endoscopic Spine Surgery
BENEFITS
There are many benefits of endoscopic spine surgery:
- Smaller incision
- Less muscle trauma
- Less blood loss
- Less infection risk
- Shorter hospital stay
- Quicker recovery time
- Less reliance on pain medication
RISKS
Studies show that complications occur less in endoscopic surgery than in open surgery. However, the risks of endoscopic spine surgery are similar to more traditional spinal procedures:
- Injury to the nerve root
- Leaking of spinal fluid, which may cause headaches after surgery
- Blood clots
- Allergic reactions or complications from anesthesia
- Infection
"I went into [endoscopic] surgery, got out of surgery, was on the road for an hour and a half, got home, and took a nap. Then I went on the treadmill and walked half a mile, with really no pain at all."
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What to Expect During Endoscopic Spine Surgery
During the procedure, your spine surgeon uses an endoscope (a tiny camera with a bright light at the tip with a series of tubes for tools and irrigation) to access your spine. Your surgeon inserts the endoscope through a small surgical cut in your skin. The incision is 7-10 mm, which is about the width of the fingernail on your pinky. The camera on the endoscope allows our surgeons to see your spine from several angles. This helps our surgeons operate around tight corners and spaces, which can't be done with traditional open surgery. Depending on your condition, your surgeon may remove the herniated portion of your spinal disk or take pressure off of your nerves without disrupting the surrounding tissues.
Most endoscopic spine surgeries do not require an overnight hospital stay. More than 90% of our patients sleep in their own bed the night after surgery.
How to Prepare
If you are scheduled for endoscopic spine surgery, our care team will guide you in preparing for the procedure. An anesthesiologist will ask you questions to evaluate the right amount of anesthesia you’ll need during surgery. Your care team may also order blood work or other preoperative tests depending on any underlying health conditions you may have. You may also need approval from your other providers before moving forward with endoscopic spine surgery.
You will need to follow these instructions to prepare for surgery:
- Maintain a healthy lifestyle and balanced diet.
- Minimize the use of narcotics (painkillers).
- Work with your provider on changes to blood thinners or blood pressure medication.
- Avoid eating after midnight the day before surgery.
Endoscopic Spine Surgery Recovery
Patients tend to recover much quicker after undergoing endoscopic spine surgery compared with more invasive procedures.
After surgery, your surgeon will advise you on the following instructions:
- Avoid showering until the day after your surgery.
- Avoid baths for a month because soaking your incision in water may increase your chances of infection.
- Avoid lifting heavy objects for a month.
- Use ice, heat, or anti-inflammatory medicine for mild pain relief.
In rare cases, your surgeon may temporarily prescribe narcotic pain medication.
Signs of Healing
During your recovery, you may experience the following symptoms:
- Return of sensations as previously numb areas begin to normalize
- Muscle twitching
- Restless legs
These symptoms are a normal part of your recovery and not a cause for concern. If you experience intense pain at the incision site or develop fever and chills, contact our team immediately.
Return to Activity
You should be able to return to work within a few days. If your job is labor-intensive, you may need to take additional time off from work until you make a full recovery.
Follow-Up Care
You will have a follow-up appointment with your spine provider six weeks after surgery. We may schedule you for another follow-up up to six months after your surgery, depending on your recovery progress. Physical therapy can improve the results of your surgery.
Endoscopic Back Surgery Success Rate
Endoscopic spine surgery has a high success rate. More than 90 percent of our patients report less pain and better mobility after surgery. Over time, you will be able to resume some activities you once had to avoid because of your spinal condition.
Schedule a Spine Evaluation
Our spine specialists at U of U Health will help you determine if surgery is an appropriate treatment for your back issues. At your first evaluation, our specialists will ask you about your medical history and determine whether endoscopic spine surgery is the best treatment to correct your back pain.
You will need a referral from your primary care provider or another specialist to make an appointment. Call 801-585-6065 to schedule your evaluation.
Contact the Destination Care Program
The Endoscopic & Percutaneous Spine Program is part of U of U Health's Destination Care Program. This program offers seamless and coordinated care for your traveling patients by providing one point of contact for system navigation and additional resources. Feel free to contact us:
Email: DestinationCare@hsc.utah.edu
Phone: 801-587-6365
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Hear From Our Specialists
What to Expect After Endoscopic Spine Surgery
Recent biomedical advancements now allow for certain spinal surgeries to be performed via a minimally invasive, outpatient procedure. For patients undergoing endoscopic spine surgery, Dr. Mark Mahan explains what to expect during your recovery—including recovery times of only a week or two.
Is Endoscopic Spine Surgery Right For You?
If you or a loved one are experiencing issues like spinal stenosis or an impacted disc, you may be considering spinal surgery. This may seem like a complicated operation with a very long recovery time, but recent advancements may make an outpatient endoscopic procedure an option for you. Dr. Mark Mahan explains how the procedure is different and whether or not you are a candidate.