Context

Eight out of 10 adults experience back pain in their life.1-2 The spine is one of the most complex structures in the human body and plays a critical role in allowing movement and providing stability. Damage due to an injury or condition can affect the spine’s ability to move like it should, and you may experience symptoms including pain or discomfort, numbness, weakness, muscle stiffness, and more.

What Is Endoscopic Spine Surgery?

Endoscopic spine surgery is an ultra-minimally invasive surgical technique performed by either an orthopedic-trained spine surgeon or neurosurgeon. Often, these procedures can be performed in an outpatient setting, potentially allowing you to go home the same day.3

Specially designed instruments like the endoscope, which is about the width of a pencil, allow surgeons to view and reach small areas of the spine without the need for the large incision required for traditional back surgery. This minimizes disruption and damage to muscles responsible for stabilizing the back and reduces the need to remove bone.

Endoscopic Spine Options

Medial Branch Transection

Treats facet joint arthritis that causes low-back pain

Surgeon will use an ultra-minimally invasive endoscopic approach to reach and view the medial branch nerve, then transect it. By cutting this sensory nerve, neural receptors can no longer receive the pain signals transmitted from nearby arthritic joints and the nerve cannot grow back to cause pain again.

Interlaminar Approach

Treats herniated discs and spinal stenosis; most commonly used to treat herniated discs in the lower back, generally at the L4-L5 or L5-S1 levels of the lumbar spine.

Surgeon will use ultra-minimally invasive instrumentation, including a spine endoscope and high-resolution camera, to reach the herniated disc in order to remove the herniated portion of the disc.

Transforaminal Approach

Treats herniated discs; most commonly used to treat herniated discs in the lower back, generally at the L3-L4 or L4-L5 levels of the lumbar spine.

Surgeon will make a small incision along the “ridge” of back above the herniated disc. The ultra-minimally invasive endoscope allows surgeon to get a direct view of the herniation and remove it.

Why Endoscopic Spine Surgery?

  • Faster recovery and return to normal activity4
  • Fewer postoperative complications and infections and less postoperative pain5-7
  • Shown to require fewer or no narcotic pain medications8
  • Smaller incisions help prevent damage to major muscles in the back9

Patient Guides

Athrex Medial Branch Nerve Transection (PDF)
Athrex Endoscopic Lumbar Discectomy (PDF)







References

  1. Zhou T, Salman D, McGregor AH. Recent clinical practice guidelines for the management of low back pain: a global comparison. BMC Musculoskelet Disord. 2024;25(1):344. doi:10.1186/s12891-024-07468-0
  2. Urits I, Burshtein A, Sharma M, et al. Low back pain, a comprehensive review: pathophysiology, diagnosis, and treatment. Curr Pain Headache Rep. 2019;23(3):23. doi:10.1007/s11916-019-0757-1
  3. Polikandriotis JA, Hudak EM, Perry MW. Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis. J Orthop. 2013;10(1):13-16. doi:10.1016/j.jor.2013.01.006
  4. Ahn Y, Oh HK, Kim H, Lee SH, Lee HN. Percutaneous endoscopic lumbar foraminotomy: an advanced surgical technique and clinical outcomes. Neurosurgery. 2014;75(2):124-133. doi:10.1227/NEU.0000000000000361
  5. Ruetten S, Komp M, Merk H, Godolias G. Use of newly developed instruments and endoscopes: full endoscopic resection of lumbar disc herniations via the interlaminar and lateral transforaminal approach. J Neurosurg Spine. 2007;6(6):521-530. doi:10.3171/spi.2007.6.6.2
  6. Polikandriotis JA, Hudak EM, Perry MW. Minimally invasive surgery through endoscopic laminotomy and foraminotomy for the treatment of lumbar spinal stenosis. J Orthop. 2013;10(1):13-16. doi:10.1016/j.jor.2013.01.006
  7. Mahan MA, Prasse T, Kim RB, et al. Full-endoscopic spine surgery diminishes surgical site infections – a propensity score-matched analysis. Spine J. 2023;23(5):695-702. doi: 10.1016/j.spinee.2023.01.009
  8. Orak MM, Gümüştaş SA, Onay T, Uludağ S, Bulut G, Börü ÜT. Comparison of postoperative pain after open and endoscopic carpal tunnel release: A randomized controlled study. Indian J Orthop. 2016;50(1):65-69. doi:10.4103/0019-5413.173509
  9. Ruetten S, Komp M, Merk H, Godolias G. Full-endoscopic interlaminar and transforaminal lumbar discectomy versus conventional microsurgical technique: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33(9):931-939. doi:10.1097/BRS.0b013e31816c8af7