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What Is Endoscopic Spine Surgery? Recovery Time, Risks, And Benefits For Back Pain

Dr. Deuk
An expert in all things spine, Dr. Deukmedjain is a board certified neurosurgeon who has performed thousands of minimally invasive surgeries and procedures including the revolutionary Deuk Laser Disc Repair and the Deuk Spinal Fusion. 

If you’ve been diagnosed with a spinal condition that has caused you to experience pain, numbness, and other neurological problems, then you may be a candidate for endoscopic spine surgery. Endoscopic spine surgery is a minimally invasive procedure that is performed through a small incision in the spine. 

In this article, you'll learn everything you need to know about endoscopic spine surgery, including the risks, benefits, and recovery time.

What is Endoscopic Spine Surgery?

Endoscopic spine surgery, also called ESS, is a more advanced, state-of-the-art form of minimally invasive spine surgery. Endoscopic spine surgery was developed to provide patients with a faster recovery period and enable them to avoid the recurring pain resulting from traditional spine surgery

Endoscopic spine surgery, by definition, is a surgical procedure that uses micro-sized incisions (usually less than 1inch) and small tubular systems, and an endoscope to visualize the surgical area/field.

The endoscope is a small camera inserted into the spine through the incision. The endoscope allows the surgeon to see inside the spine and make any necessary repairs.

How is Endoscopic Spine Surgery Performed?

Endoscopic spine surgery is referred to as a type of minimally invasive surgery that is done using an endoscope. An endoscope is a 7mm tube equipped with a high-resolution camera lens and a light source.

During endoscopic spine surgery, the surgeon makes an 8mm incision and carefully separates the muscles to provide a small pathway for the endoscope to get to the spine. The images from the endoscopic camera are projected onto a monitor, which allows the surgeon to visualize the anatomy and pathology. 

Once the images are projected, instruments are inserted through the channel to remove any problematic bone spurs, herniated discs, or thickened ligaments. After completing the procedure, the instruments are removed, and the surgeon closes the incision with sutures. 


An example of an endoscopic image during spine surgery to remove a herniated disc.


Benefits of Endoscopic Spine Surgery

There are many benefits of endoscopic spine surgery for patients. These include:

Faster Recovery

It provides rapid recovery for patients. Compared to other traditional methods which cause tissue trauma, it has minimal to no tissue trauma. This results in a shorter hospital stay and a quicker return to your regular activities.

Minimally Invasive

The surgery is performed through a very small incision, which means less tissue damage. This results in less pain and scarring for the patient.

Lower Risk of Infection

It has a lower risk of infection because the incision is very small. In addition, it does not require any implants or foreign objects to be placed in the body.

Risks of Endoscopic Spine Surgery

ESS is a minimally invasive procedure with many benefits for patients. However, as with any surgery, there are also risks involved. The most common risks associated with endoscopic spine surgery include infection, bleeding, and nerve damage. 

  • Infection: The risk of infection is low, but it is always a possibility with any surgery.
  • Bleeding: Endoscopic spine surgery involves using small instruments and cautery to stop bleeding. There is a small risk of bleeding associated with this type of surgery.
  • Nerve Damage: There is a small risk of nerve damage associated with endoscopic spine surgery. The risk is lower than with other types of spine surgery.

If you are considering this type of surgery, be sure to discuss the risks and benefits with your surgeon.

How is Endoscopic Spine Surgery Different From Minimally Invasive Spine Surgery?

While endoscopic spine surgery is a minimally invasive procedure, there are some key differences between endoscopic spine surgery and minimally invasive spine surgery.

 A big difference is the size of the incision. ESS requires a small incision, while minimally invasive spine surgery requires a larger incision. This means that ESS has a shorter recovery time than minimally invasive spine surgery.

What Conditions Does Endoscopic Spine Surgery Treat?

Endoscopic spine surgery can treat various conditions, including herniated discs, degenerative disc disease, and spinal stenosis. It can also decompress the nerves in the spine, which can relieve pain.

Herniated Disc

A herniated disc can cause back or neck pain, arm or leg discomfort and can advance into more complicated syndromes such as radiculopathy, sciatica, or myelopathy. Pain originating in a damaged disc is called “discogenic” pain.

There are 23 intervertebral discs in the spinal column. These discs are soft tissue joints composed of a hydraulic gelatinous core called the nucleus pulposus encased within a firm outer collagen wall termed the annulus fibrosus. 

The discs protect the spinal vertebrae and nerves from sudden impact and absorb shock from spine movements like bending, jumping, and twisting. 

Unfortunately, the disc's outer wall, the annulus fibrosus, can develop traumatic tears (annular tear), allowing the jelly-like nucleus pulposus to push backward out of the tear into the spinal canal or neural foramen. 

The part of the jelly nucleus pulposus that pushes out through the tear is called the herniation. In many cases, this hernia can impinge on a nerve, giving rise to inflammation and irritation of the affected nerve.

Degenerative Disc Disease

Degenerative disc disease involves various structural, biochemical, nutritional, and molecular changes that occur in the spinal disc over time or following an initial injury to the intervertebral spinal disc in your spine. 

Degenerative disc disease is a common cause of back pain and neck pain (discogenic pain), sciatica, and radiculopathy. The pain in your back from degenerative disc disease comes from irritated (inflamed or compressed) nerve fibers nearby and can be categorized as mechanical instability. Deuk Spine Institute offers a wide range of treatments for this condition.

Spinal Stenosis

Spinal stenosis occurs when, usually due to the age of the body, the spinal canal narrows and puts pressure on the important spinal nerves. Spinal stenosis is called cervical stenosis when it occurs in the neck area, thoracic stenosis in the middle to the upper part of the back, and lumbar stenosis in the lower back area. 

Narrowing can happen for several reasons, such as ligaments and cartilage thickening in the canal or excessive bone growth, causing the opening to become more slender over time. The risk of this problem increases as a patient passes 50 years of age, due in part to years of stress on the spine and the tendency of tissue and bone to become less sturdy or flexible with decades of repeated use. 

Bone disease or spinal injury may also contribute to stenosis of the spine in patients of any age.

Endoscopic Spine Surgery Cost

Endoscopic spine surgery is less invasive and has a shorter recovery time than traditional open spine surgery. It can also be used to treat various conditions, including herniated discs, degenerative disc disease, and spinal stenosis. 

The cost varies depending on the severity of your condition and the type of procedure you need. While, it is typically covered by insurance, you may have to pay a deductible or copayment.

Endoscopic Spine Surgery Success Rate

This spine surgery has a high success rate, with patients typically seeing a significant reduction in pain and improved function. Endoscopic spine surgery is generally safe, but as with any surgery, there are risks involved. These risks include infection, bleeding, and nerve damage.

Endoscopic Spine Surgery Side Effects

The side effects are typically mild and resolve on their own within a few days or weeks. The most common side effects include pain, swelling, and bruising at the incision site. You may also experience temporary numbness, tingling, or weakness in your arms or legs.

Endoscopic Spine Surgery Recovery Time

Endoscopic spine surgery recovery time is typically shorter than traditional open spine surgery. Most people can return to their normal activities within a few days or weeks.

Is Endoscopic Spine Surgery Safe?

Endoscopic spine surgery is generally safe, but as with any surgery, there are risks involved. These risks include infection, bleeding, and nerve damage. Endoscopic spine surgery is a minimally invasive procedure, which means that it uses small incisions and requires less recovery time than traditional open spine surgery.

Types of Endoscopic Spine Surgery

The following are types of endoscopic spine surgery:

1. Microdiscectomy

This is a type of endoscopic spine surgery performed on patients who suffer from a herniated disc. Microdiscectomy involves removing the herniated material that causes the pain. 

Microdiscectomy was first performed on a herniated disc in the 1970s, and since then, there have been significant advancements in technology and how the procedure is performed.

The procedure for microdiscectomy is straightforward and aims to: 

  • Remove the excess disc tissue that irritates the spinal nerves.
  • Relieve inflammation.
  • Treat any symptoms the patient may have.

The procedure is done with the patient lying face down and under general anesthesia. During the procedure, the patient is unconscious and feels nothing.

The process for microdiscectomy includes the following:

  • The surgeon makes an incision of 1-2 inches directly over the affected area.
  • The surgeon uses an endoscope to inspect the affected area.
  • Next, the surgeon will remove the intruding herniated tissue that puts pressure on the nerve using specific surgical tools. They will also remove some of the bone that protects the root nerve if necessary.
  • They will then remove the tools and tubes used and close the incision with sutures.
  • You will then be moved to the recovery room, where you can gently come around from your anesthesia.

2. Deuk Laser Disk Repair

Deuk Laser Disc Repair is a form of endoscopic spine surgery performed in a state-of-the-art outpatient surgery center under sedation while the patient relaxes. This procedure does not compromise or weaken the health and integrity of the spine.

In over 15 years of performing this procedure and over 1,300 patients treated, there has been a 95% success rate with no complications.

How Deuk Laser Disk Repair Works

To get started, Deuk Laser Disc Repair requires a very small incision, less than a quarter-inch long. A cylindrical rod called a dilator is inserted in the small opening to gently spread the muscle to create a small passage and guide through which the surgery is performed endoscopically. 

The tip of the dilator is advanced into the symptomatic disc through the tear in the annulus where the herniation originates, and a tube called the retractor slides over the dilator and is carefully positioned into the painful disc. The rest of the entire Deuk laser disc repair surgery will occur inside this narrow tube.

To access the spine, an endoscopic camera is inserted into the tubular retractor to allow the surgeon to guide the laser inside each symptomatic disc. This process ensures that bones and surrounding tissues are not damaged, unlike traditional spinal fusions, microdiscectomy, and artificial discs.

The Holmium YAG laser used in the Deuk laser disc repair is manipulated accurately with millimeter precision under endoscopic visualization to remove only painful inflammatory tissue from the disc. The laser is precisely used to remove damaged disc material that is causing the pain. 

Once the laser has removed the inflamed, painful part of the annular tear and the herniated nucleus pulposus, the endoscope and tubular retractor are removed, leaving less than one-quarter inch incision in the skin, which can be closed with a single stitch and a band-aid. 

The total time for the Deuk laser disc repair surgery is one hour, and the patient is in recovery for about 45 to 60 minutes before being released to go home. Hospitalization is not needed, and the risks of hospital-based surgery are avoided. 

Also, with the Deuk laser disc repair, there’s no loss of normal movement, and the flexibility of the disc and joint is preserved. With endoscopic Deuk laser disc repair, there is no fusion, metal implants, or biological material added to the spine. The procedure is all-natural, allowing your body to heal the herniated or bulging disc.

After the surgery, the Deuk laser disc repair patient is back home, enjoying life with a speedy recovery allowing normal activities without pain. Another advantage of Deuk laser disc repair is that no opioids or powerful narcotic painkillers are needed after surgery. 

Open spine surgeries like microdiscectomy, laminectomy, artificial disc replacement, and fusion cause so much internal trauma that patients are in severe pain after surgery and must take painkillers for weeks after their surgery but not with Deuk laser disc repair.

Here’s what one of our patients had to say one hour after Deuk Laser Disc Repair:

Patient-oriented Care

In the United States, endoscopic spine surgery is relatively new in the treatment of spinal disorders. These procedures require a very unique combination of training and skill that takes time to acquire. 

If you’re suffering from chronic back and neck pain and are looking for a well-equipped clinic that handles endoscopic spine surgery, you should contact us at Deuk Spine Institute today. Dr. Ara Deukmedjian, the founder of Deuk Spine Institute, is a renowned neuro-spine surgeon and a true pioneer in minimally invasive, laser, and endoscopic back, neck, and thoracic pain treatment.

At Deuk Spine Institute, you can be rest assured that you’re in safe hands. Visit our site here to start your treatment.

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About Deuk Spine Institute
World leader in Laser Spine Surgery
With world-class physicians on staff, the newest and most advanced technology, and a patient experience pathway that is unrivaled in it’s efficiency and and pedagogy of care, Deuk Spine Institute has performed thousands of procedures and achieves a 95% success rate in elimination of pain.

 The services we offer are not offered anywhere else in the world, and the treatments are curative, not palliative.  On top of that, Dr. Deukmedjian is personally invested in the well-being of each and every patient, and has spared no expense to guarantee the best possible outcomes.
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