For patients with spinal stenosis or lumbar disc herniation who are offered surgical treatment, the objective of the intervention is to decompress the nerves to alleviate symptoms of sciatica, leg pain, or difficulty walking.
Minimally Invasive Techniques (MIS) in spine surgery achieve this goal with less collateral damage than conventional surgery, such as reduced bleeding, less muscle injury, and therefore faster postoperative recovery. In other words, MIS surgery successfully releases the nerves, avoiding pain and the consequences of the surgery itself.
Clinical studies have shown that the best predictor of long-term symptom improvement (in the following years) is short-term improvement (in the first few months), and that this improvement depends on:
- proper nerve decompression
- minimal damage to muscles, ligaments, facet joints, the epidural space, and the nerve itself during surgery.
In my experience, patients with symptomatic disc herniation who undergo surgery within the first three months using Minimally Invasive Techniques have better outcomes than those who, due to circumstances (waiting lists, recommendations from non-spine specialists…), do not undergo surgery until 6 months or more have passed.
All cases of disc herniation can be correctly resolved with microsurgery, but thanks to current technology, endoscopic techniques offer a series of advantages to consider:
- The endoscopy camera is inserted into the spine’s natural spaces without the need to separate nearby structures; in this way, it reaches the problem directly and records the surgery.
- The use of water irrigation limits epidural bleeding and helps separate the herniation from other structures. Furthermore, continuous irrigation prevents postoperative infections.
- Just as the mark on the skin is small (a 1 cm scar), postoperative MRIs show that the surgical footprint inside the spine is minimal, and the formation of fibrosis is very rare.
- The surgical equipment we have is the same as that used for microsurgery but specifically designed for use through the endoscopy camera (uniportal technique).
- Patients can be discharged on the same day after recovering from anesthesia if they wish, as postoperative pain is minimal.
Technology helps us develop new techniques with extensive benefits for patients. Why settle for conventional surgery when better techniques exist?
If you have been proposed surgery for spinal stenosis or a disc herniation, consult us to see if it can be performed via endoscopy.
A History of Endoscopic Lumbar Spine Surgery, what have we learnt? Biomed Res Int 2019: 4583943
