Endoscopic Spine Procedures
Unlike open surgery, endoscopic spine surgery allows access to spinal pathology through a tiny opening to preserve tissue. With an endoscopic procedure, patients are able to be treated and return to every day activities quicker than if they had an open surgery procedure. Much like knee and shoulder arthroscopy, spine endoscopy uses an endoscope to show the surgeon all the anatomy without causing collateral damage to healthy tissue. Your physician may choose to provide this unique solution for addressing a variety of spine pathologies that are addressed through a minimally invasive approach.
Why would I require an endoscopic procedure?
Some common indentifiers for back surgery are low back pain and pain radiating down your leg (sciatica). This indicates that you may have a herniated disc which can be treated endoscopically. Simple aging of the spine may create the need for an endoscopic procedure. As we grow in age, the spine can decrease in strength and can cause a collapsed disc, causing pressure on nerves that results in pain.
Procedure Overview Spine endoscopy allows access to the anatomy and is done with a series of small instruments that ultimately allow for the placement of a working channel scope to visualize the pathology that is causing the pain and correct it, or remove it. This can be related to disc herniations or bony overgrowth (hypertrophy). Patients are generally under light anesthesia and are able to return home the same day with restricted activity.
Anatomy of the Spine There are 7 cervical (neck), 12 thoracic (chest), five lumbar (back), and five sacral (tail) vertebrae. The spinal cord has nerve roots that exit the spinal canal between the vertebral bodies. Spinal cord segments or levels house the nerve roots that pass through them but are not always situated at the corresponding vertebral levels.
Before and After the Procedure and the Risks
What type of pain can be treated? Low back and leg pain due to contained disc herniations. How does the procedure work? The DEKOMPRESSOR discectomy probe removes disc tissue which may relieve painful pressure on the surrounding nerves.
Will the procedure hurt? There should be no pain generated by the DEKOMPRESSOR discectomy probe. This advancement in technology requires only a tiny puncture in the skin; similar to a simple injection.
How long does the procedure take?
The total procedure time is generally 15 minutes to 1 hour. What physician training is required to perform this procedure? Board certification in a specialty such as interventional pain management, orthopedic surgery, neurosurgery, radiology, or physiatry is typical. Physicians should be experienced with discography. Can my pain be cured?
In some cases, pain may be eliminated. In most cases, percutaneous discectomy followed by appropriate follow up care will reduce pain to a tolerable level.
Before the procedure
Here are some guidelines to help you prepare for your procedure. Your physician may recommend other specific instructions.
- You should bring any recent x-rays, MRI films, and reports to your procedure.
- Notify your physician of your daily dosages including; blood thinners (such as coumadin, lovenox pavix, etc.), vitamins, and herbal supplements.
- Notify your physician of any of the following; allergies to medications or iodine, current infections, high blood pressure, asthma, diabetes, or abnormal conditions you may be experiencing including colds or respiratory problems.
- Do not take aspirin or ASA containing products (including Alka-Seltzer or Pepto-Bismol) for 5 days prior to your procedure.
- Do not take herbal remedies including ginkgo biloba for 5 days prior to your procedure.
- Do not take NSAIDS (such as ibuprofen) for 3 days prior to your procedure.
- Do not take food or drink 6 hours prior to your procedure except necessary and allowable medications with sips of water.
- Arrive at least 30 minutes prior to your scheduled procedure time.
- Be prepared to review and sign a consent form.
- Arrange for transportation home from another person following your procedure.
After the procedure
- You will spend about 15 minutes in a recovery room where monitoring is continued immediately following the procedure.
- You will need to arrange transportation home from another person.
- You should apply periodic ice on the treatment area 1 to 2 hours per day for 3 days.
- Plan on bed rest with gentle stretching for 1 to 3 days. Limit sitting or walking to less than 30 minutes at a time. Limit driving, bending, twisting, and lifting of weights over 10 pounds for 3 days.
- Prescriptions or non-prescription pain and anti-inflammatory medications may be required for 3 to 30 days.
- Plan on a slow return to your normal routine.
- You may be able to return to work in about 3 days depending on your job function.
- A stretching program under the direction of your physician, physical therapy, and chiropractic care should begin after 7 days.
- Limited physical activity may begin following 30 days.
- Plan on conservative physical activity for up to 3 months.
- Back braces or supports are not necessary but may improve your recovery.
- Your physician may recommend other specific post-procedure instructions.
- Recovery time varies with each patient.