Endoscopic techniques for diagnostic purposes have been in use since the late 1970s. The endoscopic surgery techniques that became widely used in the 1990s for other surgery disciplines are now available for the treatment of spine conditions. Using special instrumentation and video cameras, spine surgeons can now perform surgery through small incisions (about the diameter of a U.S. penny).
During endoscopic spine surgery, in order to minimize interruption to muscles and tissue, the surgeon gains access to the vertebrae by placing a series of tubes. Endoscopic spine procedures are generally performed in an outpatient setting or 23 hour stay.
This minimally invasive spine surgery is used to relieve pain caused by herniated discs pressing on nerve roots.
During an endoscopic procedure, the spine surgeon makes a small incision through which a guided wire is inserted. The guide wire is used to locate the damaged disc level. A fluoroscope (specially designed X-ray machine) is used to ensure the correct path is made to the affected disc.
The surgeon will next use a number of dilating tubes placed over the guide wire to move apart the tissue to the vertebrae. After this the surgeon removes the guide wire. The procedure is performed through a tubular retractor which is placed over the dilating tubes and onto the bone surface. After the retractor is in place, the surgeon removes the dilating tubes.
A small camera and special surgical light are used to view through the tube. Surgical instruments are used gain access to the spinal canal and move away soft tissue and bone. The nerve is separated from the damaged disc by a nerve retractor. The surgeon next removes the herniated portion of the disc and cleans the area. The nerve then returns to the normal position.
At the end of the endoscopic spine procedure, the tubular retractor is removed, this allows the tissue to enclose the surgery area. Only a small bandage is needed to cover the incision area.