What is minimally invasive spine surgery?
It is spine surgery with a skin incision less than 1-inch, but it is more than just a small incision. The surgery is done through a tube in between back muscles to decrease muscle damage and weakness caused by muscle retraction. Minimally invasive surgery is not the same as “microsurgery”. “Microsurgery” only refers to the use of a microscope not the size of the incision or the amount of muscle damage.

How is endoscopic laser spine surgery different then minimally invasive surgery?
Endoscopic spine surgery is state-of–the-art minimally invasive spine surgery. A micro video camera is inserted through a very small incision to the damaged area of the spine. The camera projects the images onto a video screen so the surgeon can easily visualize the pathology. Tiny instruments are inserted through the camera to repair the spine under direct visualization. The media often emphasizes lasers but they are only one of many endoscopic instruments.

Why is endoscopic spine surgery better than traditional surgery?
Traditional surgery is more destructive in its approach to the spine for the problem being treated. The larger the incision the more damage to muscle, ligaments and bone. This collateral tissue damage may result in more pain, back muscle weakness (erector spinae), instability and scar tissue leading to future difficulties.
Endoscopic spine surgery is extremely minimally invasive, even for minimally invasive spine surgery. The incision is very small, often less than 1 cm in size. There is minimal damage to skin, muscle, ligaments and bone. No general anesthesia is required decreasing medical risks and improving access to surgery for high-risk patients. There is very little blood loss. These benefits result in less post-operative pain and quicker recovery.

What types of conditions can endoscopic spine surgery treat?
Treatment is effective for conditions that cause back pain, leg pain, numbness and weakness, such as bone spurs, bulging discs, herniated disc, facet joint disease, sciatica, scoliosis, spondylolisthesis, stenosis and others. Due to the many advantages of endoscopic spine surgery it should be always considered, but currently it is not a replacement for all spine surgeries. The indications are rapidly increasing with the advancement of surgical techniques and equipment.

Why can it help people others surgeries cannot?
Traditional surgery is limited because the surgeon requires direct vision of the pathology with their eyes or microscope. The endoscope camera visualizes areas that are not usually accessible, through nerve root foramen and around corners. This greater visualization combined with less damage and surgical risk increases the spectrum of pathology that can be treated safely. This allows treatment of spinal disorders traditional surgery may not treat. This happened many years in orthopedics with introduction of endoscope to knee surgery. Today no one doubts the incredible benefits of endoscopy of the knee. We are seeing this happen in spine surgery.

Can it help everyone?
Not everyone can be helped or will be satisfied with endoscopic spine surgery. It is still spine surgery. Endoscopic spine surgery is the next advance in the treatment of spinal disorders.

Why is not all spine surgery done this way?
These procedures require a unique combination of skills that take time to acquire; it is a hybrid procedure that falls in between interventional pain and minimally invasive spine surgery. They are cutting-edge techniques. Endoscopic spine surgery is the future.

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