Endoscopic spinal surgery is a minimally invasive spine procedure used to treat back pain and sciatica such as stenosis, spinal arthritis, and disc hernia. In this surgery, a series of small surgical tools along with a small video and monitor allows the surgery to be operated without opening large portions of the back, paving way for a safer surgery without any damage on the connecting tissues. Not all minimally invasive spine surgeries use an endoscope. Instead, direct visualization and magnification to view the organs and spine are followed to allow the least disruption of the body.
Types of Endoscopic Spinal Surgery
- Endoscopic Discectomy of the lumbar and cervical spine – a surgery to remove herniated disc material that causes pain in the lumbar (the lower back and legs region), mid-back (thoracic), and the cervical (arms and neck).
- Endoscopic Foraminotomy – caused by compression from bone spurs, scar tissue, herniated discs, and excessive ligaments, it is a surgery to relieve pressure on the spinal nerve roots.
- Endoscopic Facet Rhizotomy – the surgery is for chronic back and neck pain but cutting off medial branch nerves which simply serves as a sensory function.
- Endoscopic Lumbar Laminotomy – an advanced alternative surgical procedure to traditional Laminotomy to treat spinal stenosis.
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Indications for Endoscopic Spinal Surgery
- You have been diagnosed with spinal stenosis, sciatica, bulging or herniated disc or any other chronic spine conditions.
- There has been no successful treatment with conservative treatments like physical therapy, chiropractic care, or pain medications.
- You have had an open spine surgery with no relief.
- You also have trouble sleeping, standing for a certain length of time, exercising, or doing daily activities.
Diagnosis and Tests
- Physical examination of the spine
- MRI Scan
- CT Scan
- Nerve Conduction Velocity
- Blood and urine tests
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- Your doctor will take a complete physical examination of your spine and body.
- Diagnostic tests recommended by your doctor should be duly done.
- Inform your doctor of all medical history including allergies and current medications.
- You will be asked to stop taking certain medications like blood thinner if you are taking any or any non-steroidal anti-inflammatory medications, diabetic medicines, or herbal supplements.
- Through your tests and review, your doctor will discuss the best spine surgery available for you.
- You must stop smoking if you currently do as it slows down the process of healing.
- You must not eat or drinking 8 – 12 hours before surgery.
- Any medication given by the doctor should be taken with small sips of water.
- No jewellery, make-up, contact lenses, or lotion should be worn on the day of surgery.
- You will be given local anaesthesia so that your back will be numbed, and you won’t feel any pain while being awake.
- The surgery may take about an hour.
- You will also have an IV line in your arm and antibiotics will be given to you.
- The spine surgeon makes a small incision on the particular area and a thin guide wire is placed under X Ray control down to the area that needs to be operated or a set of tubular dilators are used to allow specialised instruments to operate.
- Depending on the type of surgery, different micro-surgical instruments may be used, armed with an endoscope and light to remove the bone spurs, herniated discs, tissues, or stenosis.
- The incision area is then given a dressing and closed with a bandage.
- Recovery after discectomy is quick but for the rest, it may take time.
- You may be able to go home on the same day or spend one or two days in the hospital depending on your recovery.
- You may feel some discomfort and pain which can be taken care of by having some pain medication.
- Eating well balanced food rich in fibre and protein goes a long way in healing along with eating plenty of fresh fruits.
- Depending on your surgery, you may be able to do light physical activities like walking, but it may take several weeks for you to get back to proper functioning.
- You may be required to wear a back wrap/brace post-surgery to ease tension and stress on your spinal discs, bones, and muscles.
- Sleeping on your back is the best position after surgery. You may place a towel or blanket underneath your knees to bend your hips slightly. Sleeping in a recliner chair or wearing a sleeping night brace will help you sleep comfortably.
- You will be asked to go for a follow-up after several weeks and examination and X-Ray be done to see improvements.
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Risks and Complications
As with any surgery, spinal endoscopic surgery has its risks and complications such as:
- Excessive bleeding
- Nerve damage
- Leaking of spinal fluid
- Blood clots
- Nerve damage
- Pain at the graft site
- Lack of relief
- Reaction to anaesthesia
Factors affecting the cost of Spinal Endoscopic Surgery
The cost of Spinal endoscopic surgery starts from $6500. However, cost price can change depending on factors like:
- Location of the hospital
- Choice of hospital
- Cost of diagnostic tests
- Medical care
- Duration of hospital care
- Surgeon’s fee