Endoscopic surgery of the lumbar spine
An innovative and minimally invasive method of treating spine diseases
Endoscopic spinal surgery is currently the least invasive surgical treatment option for patients with disc herniation. When operating endoscopically, a very small fibre-optic tip is inserted along with a powerful light source through a minimal skin cut deep into the surgical field and sits directly on the spine. For the patient, this technique is ideal: there is no need to prepare individual layers, there is no need to damage the spinal muscles and the instruments are introduced directly into the affected area. Less damage means less pain, but also instant recovery from surgery and home discharge.
The endoscope also means additional benefits for surgeons. Above all, it provides the comfort of an image directly from the operative site. The surgery is performed in a preview displayed on a huge 4K screen, the image is pristine thanks to excellent illumination. In addition, the camera can look into places that are currently inaccessible without removing sometimes even quite large sections of the spine. This creates completely new possibilities, e.g. to reach areas of spinal canal stenosis without interfering in the structure of the spine. An additional, not insignificant benefit is that the thickness of the fat tissue does not affect the view of the surgical field. In the case of microdiscectomy in obese patients, the skin cut can be up to 10 cm which translates into recovery time.
Indications for endoscopic surgery:
- herniation (bulging) of the intervertebral disc
- spinal stenosis (narrow spinal canal)
- symptoms of pressure on the nerve roots: sciatic, brachial and femoral pain, difficulty in walking, numbness, paresis
- no improvement after 3-4 weeks of conservative treatment/rehabilitation
Course of surgery
There are two access routes in the endoscopic method.
In the so-called transforaminal technique, the endoscope with its instruments is inserted through the intervertebral foramen from the side. It is a very convenient access for the surgeon because there is virtually no need to prepare the tissues along the way. A skin incision about 8 mm long is located about 20 cm laterally from the spine. A long endoscope is inserted into the spinal canal under X-ray control into the immediate vicinity of the bulging, which is then removed with forceps.
The so-called interlaminar technique means access almost in the midline. A skin incision of similar length as in the aforementioned access is located approx. 1 cm from the spinous process. A slightly shorter endoscope is then inserted into the canal through the yellow ligament, analogous to microdiscectomy. Using a special tube, the nerve roots are pulled out and then the hernia is removed with forceps.
- The least invasive procedure
- No interference with the mechanical structure of the spine
- Excellent view of the spine and possibility of precise hernia removal
- Quick verticalization – one hour after surgery
- Quick recovery and return to full fitness
Endoscopic surgery is safe for patients, the risk of complications is low. If complications do occur, they are usually mild and transient.
Possible complications include:
- lack of improvement, persistence of complaints
- damage to the root, which may manifest as pain, numbness or muscle weakness in the limb
- occasionally cerebrospinal fluid leakage
- due to the small cut, the risk of infection is minimal
approx. 40-60 minutes
Duration of hospitalisation:
The procedure is performed as a one-day surgery. The patient can go home the next day after the procedure
approx. 2-4 weeks
Recommended depending on the health patient’s condition. Additional rehabilitation packages are available at the Vratislavia Medica hospital