What to know about spinal endoscopy

Spinal surgery is a procedure that carries a significant number of risks due to the spine’s central position in the body and its delicate, intricate construction. In the past, the procedure was majorly invasive and came with an extensive recovery period. However, innovations in surgical techniques mean that some patients can evade many of the downsides – both inevitable and possible – of the surgery. One such key technique is the endoscopy. In this article, a consultant neurosurgeon explains how endoscopic spinal surgery works, and what patients can expect. 

Back pain is not only caused by bad posture and lumpy mattresses, but can also be due to a range of serious conditions like degenerative spine diseases, disc displacement, and cervical spondylosis. Conditions like these often require surgical intervention to investigate, correct, or prevent further damage. But the spine is a complex network of bones and nerves, where issues can lead to lifelong pain and paralysis when left untreated.

Spinal endoscopy is an emerging technique that allows surgery to be performed using a thin tube through which ultra-fine surgical tools can be inserted to perform the procedure.

How does spinal endoscopy work?

A special camera, called the endoscope, is used by surgeons to amplify their view of the operation site and perform the surgery without the need for open access. Small incisions, up to 2cm long, are made along the spine or at the tailbone, through which small, fine surgical instruments in addition to the endoscope are able to be inserted and manoeuvred to conduct the treatment.

The advantages of spinal endoscopy

Endoscopic spinal surgery has a number of advantages over open surgery, including:

• high success rates
• minimal or no blood loss
• no removal of muscle or bone
• reduced need for pain medications
• preservation of spinal mobility
• immediate recovery with the patient able to go home the same day
• minimal scarring and damage to muscles

Risks and complications of spinal endoscopy

In experienced hands, the complication rates for this procedure are low, and the patient can walk and be discharged on the day after surgery – depending, of course, on their condition. Complications can, however, include nerve injury or a tear to the lining of the nerves (durotomy), which can result in a longer stay in hospital.

Which spinal conditions can be treated with endoscopic techniques?

One of the most common procedures that can be performed endoscopically is treatment of a slipped disc. The disc can be treated by either removing the bulging fragment, or using laser to:

• vaporise a small part of the disc material
• destroy pain-generating nerves inside the disc
• toughen the disc against further prolapse

Other spinal conditions that can be treated endoscopically include:

• disc tears
• radiculopathy
• nerve pain
• sciatica
• spinal stenosis