Endoscopic Spine Surgery

Classic spine surgery requires wide incisions due to the necessity to see the tissues to intervene, to control the bleeding (hemostasis) and to have space for the instruments the surgeon uses.

Currently, with technological advances, a patient can be operated through a minimal incision in the skin, visualizing the structures and tissues through fiber optic on a TV monitor, without bleeding problems and using fine highly evolved instruments. That’s what endoscopic spine surgery is all about.

Spine endoscopy is a procedure in which a small endoscope is introduced through the coccyx into the epidural space. This lets the surgeon see pictures and direct video from inside the spinal canal. Spine endoscopy is also known as epiduroscopy because the endoscope is observed within the epidural space.

During a spine endoscopy, we try to remove part of the scar tissue or adhesions of the trapped nerves. Spine endoscopy may allow the drug to reach the affected areas, especially the roots of the spinal nerves.

Spine endoscopy is used more frequently in patients who have had lumbar spinal surgery before. In some cases, patients who have not had any back surgery but who have not responded positively to other treatments can also undergo spine endoscopy. Spine endoscopy is usually used when other more conservative treatments have not been effective.

Advanced spinal endoscopy is a very innovative minimally invasive technique, it has not stopped evolving during the last 20 years, creating new methods and surgical accesses to approach the spine.

We can treat pathologies such as herniated disc and canal stenosis, simply with an approach that requires an incision of less than 1 cm in the skin.

It consists of the exploration of the spinal canal through a high definition optic that provides a light source. It is used mainly an endoscopic camera with a channeled optical system connected to a high definition television screen.

Through the optic channel, we use the different clamps and surgical instruments necessary for the treatment of the different pathologies. .

 

Advantages

  • It is a minimally invasive surgery that only requires a small incision of 2 millimeters without leaving a scar.
  • Allows to expand and magnify the field.
  • The relief of sciatic and lumbar pain is immediate.
  • The risk of injury, bleeding, and aggression to the musculature is lower, which reduces postoperative risks.
  • Hospitalization is not required and is performed by local anesthesia.
  • The duration is approximately 20 minutes per disc.
  • The recovery time is reduced, allowing a faster incorporation to the patient’s normal and work activity. The return to normal life occurs 24 hours after the intervention and it is possible to perform a rehabilitation after only 15 days of the intervention.
  • It diminishes, and even disappears in some cases, the ingestion of drugs in the postoperative period.

Post-operative spinal endoscopic surgery

With a surgical wound about 0.5 cm in the lateral or posterior area of the lumbar zone, it is usually given a stitch or a staple at the end of the endoscopic spine surgery

Normal activities can be done from day 5. It is necessary to perform wound antiseptic washing. We must maintain the wound clean and dry. No lumbar belt is necessary.

Contrary to others wound, the complication of infections and opening are minimal, this is because of its small length and size.

Thanks to its small size, there are usually no complications of infection or openings of the wound. And after 15 days, physical activities should increase in difficulty.

It is recommended making movements such as rotation and lateralization which stimulate the thoracolumbar spine. In the first month you must avoid any bad posture and handling heavy things.

Most common pathologies where endoscopic spinal surgery is recommended :

  • Herniated discs
  • Lumbar canal stenosis

The spine is a complex articulated osteofibrocartilaginous structure that is composed of 33 vertebrae and their respective intervertebral discs, as well as ligaments and musculotendinous masses that connect and sustain these structures.

The main functions of the spine are:

Dampens the effort presented by everyday activities such as walking or more strenuous activities such as running and jumping.

Protects the spinal cord, acts as a support to the head and is the space for insertion of the ribs, the pelvic girdle and the muscles of the back.

It maintains the center of gravity of the human body.

It provides Flexibility

It generates Stability

Cervical disc herniation

The cervical disc hernia is the displacement of the soft center of the intervertebral disc towards the outside by the rupture of the annulus fibrosis, this causes pressure on a nerve root of the medullary canal. We talk about this pathology when the affected area is in the region of the neck of the spinal column between the third (C3) and the seventh cervical vertebra (C7).

Main causes:

Age. From the 20’s, begins the progressive degeneration of the intervertebral joints.

Repetitive movements of trunk flexion and extension supporting the weight, especially in the case of certain professions or sports.   

Symptoms:

Continued pain in the neck irradiated by the shoulder, arm and/or fingers. It may be accompanied by other signs such as, for example, nighttime disorders, decreased sensitivity, weakness, dizziness and/or tingling in the arm and/or hand.

Numbness and/or tingling in the shoulder and/or arm.

Impaired gait, sphincter involvement, altered sensation and/or loss of strength in the upper extremities.

Lumbar disc herniation

The lumbar disc herniation is the rupture of an intervertebral disc located in the lumbar region of the spinal column between the first (L1) and the fifth (L5) vertebra. When the ring is broken, there is a displacement of the soft center of the intervertebral disc towards the outside, causing a compression of some nerve roots and intense pain.

Main causes:

The aging of the spine. While we age, the intervertebral joints progressively degenerate. Interestingly, the discs of some people subjected to the same activity degenerate before others, but, nevertheless, the reasons are unknown.

Atrophy of the musculature that is next to the vertebrae of the lumbar area.

Overweight, obesity and weight gain during pregnancy.

Professions in which you have to perform repetitive movements, load heavy weights or the column suffers vibrations.

Excessive overload on the intervertebral disc.

Symptoms:

Sciatica or sharp pain in the leg. It may or may not be accompanied by low back pain.

The sensation of numbness, cramping, tingling, weakness, loss of sensation, tingling and/or pain in different degrees in the leg.

Pain in the lower back, back and/or buttocks.

Although infrequent, the patient may experience a lack of control of the sphincters associated with the medical condition of the cauda equina syndrome.

Lumbar canal stenosis:

Stenosis of the lumbar canal is a pathology that occurs when the space surrounding the spinal cord (spinal canal) is reduced. This causes the “strangulation” of the spinal cord and the roots of the spinal nerves may cause pain, numbness or loss of strength in the legs.

Causes of lumbar canal stenosis:

Increase in size of the bones and tissues that are around the lumbar spinal canal that occurs over the years, which means that the canal becomes narrower.

Osteophytes: the appearance of extra bone around.

Through time, the vertebral discs degenerate and lose water, which leads to a decrease in their natural cushioning

Herniated discs protruding into the medullary canal invading it.

Symptoms:

Loss of strength, weakness, cramps and/or numbness in the legs and/or back.

Pain in the lower back.

Pain in the legs similar to sciatica but can reach the soles of the feet.

In severe cases, partial or complete incontinence of the bladder and/or intestines.

This surgical technique in the hands of experts like ours, ensures a simple approach and rapid recovery, however, is reserved for medical specialists dedicated to the daily performance of this surgery, so it reaffirms its greatest success. Our team of professionals is highly trained to adequately solve these types of pathologies.

Call Spine Center Atlanta at 404-351-5812 to see if an endoscopic spinal surgery is right for you.