Endoscopic Spine Surgery
Endoscopic spine surgery is one of the minimally invasive spine surgeries. It uses modern technology and surgical techniques with the aim to minimize tissue damage, especially muscle injury, while achieving treatment outcomes comparable to conventional open surgery.
Endoscopic surgery is considered the gold standard for certain types of surgeries, such as knee ligament surgery and shoulder ligament repair. Currently, endoscopic spine surgery has been continuously developed and is becoming more widespread in some areas, offering an interesting alternative.
The principle involves surgery through an endoscope smaller than 1 centimeter, using a single portal and a water system to provide clear visualization (lens optic under fluid) and reduce bleeding during surgery. The procedure is viewed on a monitor during the operation.
Advantages of Endoscopic Surgery
- Operates under excellent visualization
- Minimized damage to tissues and bones (minimized resection of bone and ligaments, possible reduction of surgery-induced instabilities)
- Small incision about 1 centimeter, less pain, and reduced hospital stay
- Reduced epidural scarring, making subsequent surgeries less difficult
- Shorter surgery time with experienced surgeons
Indications for endoscopic surgery
- Lumbar disc herniation (all types and locations)
- Spinal canal stenosis compressing nerves, especially patients with unilateral radiating back pain and clear pathology at a single level
- Facet cysts
Postoperative Care
- Hospital stay for 1-2 nights after surgery
- Can walk immediately after surgery
- If stitches need to be removed, remove them 2 weeks after surgery
- Wear a lumbar support (L-S support) to rest tissues and help remind to limit activity for 4 weeks
- Can return to work in 2-4 weeks depending on the type of work
Complications may occur similar to conventional open surgery but are less frequent, such as discitis, wound infection, dural tear, and the possibility of converting from endoscopic to open surgery. The recurrence rate of disc herniation compressing nerves is about 6%.
Currently, endoscopic surgery is becoming more popular and is expected to become more widespread in the future. This method is attractive, interesting, and effective. It involves small incisions, minimal tissue damage, less postoperative pain, shorter hospital stays, and is applicable for all types of lumbar disc herniation and single-level spinal canal stenosis (lateral recess or central spinal stenosis) as well as facet cysts, with treatment outcomes comparable to conventional open surgery.
Dr. Prusnai Prutthikul
Orthopedic and Trauma Surgeon
Musculoskeletal Institute
Phyathai 3 Hospital
