What to Expect from Endoscopic Spine Surgery

By The Spine Center

Chronic back pain is one of the top causes of missed work days in the United States. If you’ve struggled with back pain and aren’t getting relief from medications or physical therapy, your doctor may recommend endoscopic spine surgery.

Endoscopic spine surgery (ESS) is much less invasive than traditional open surgery, which requires large incisions and a long recovery time. At The Spine Center at the Bone and Joint Clinic of Baton Rouge in Baton Rouge, Walker, and Prairieville, Louisiana, our spine experts perform ESS to alleviate both facet joint pain and pain caused by a slipped vertebral disc.

Understanding what happens on the day of your surgery helps you prepare, both physically and psychologically. Both types of ESS procedures are minimally invasive and performed on an outpatient basis. 

ESS targets inflamed facet joint nerve

Our experts may recommend an ESS procedure called endoscopic rhizotomy if you have pain and inflammation in the facet joints of your lumbar spine. When you develop arthritis or inflammation in a facet joint, the irritated tissue presses against the medial branch of the nearby nerve. 

A rhizotomy destroys the nerve, so it can’t send pain signals to your brain anymore. Our doctors first verify the position of the nerve by injecting it with a nerve block agent to dull the pain. If you notice pain relief after the injection, they then proceed to destroy the nerve.

During the procedure, you lie face down on the treatment table, with a pillow underneath your abdomen to straighten your spine. We only administer local anesthesia, so you’ll be awake for the operation.

The endoscope is a narrow tube equipped with a miniature camera. Your doctor inserts the endoscope percutaneously (i.e., through a needle). 

The camera allows your doctor to visualize the nerve directly, so they can destroy it without harming surrounding tissue. The channel of the endoscope also contains a probe, through which your doctor sends either laser or radiofrequency (RF) energy.

While watching the procedure onscreen, your doctor severs the offending nerve with the laser or RF energy. The energy is at such a high frequency that it prevents the nerve from regenerating, so that your pain relief lasts.

Your doctor closes the insertion point with a suture and bandage. After two days, you can resume your normal activities.

ESS repairs torn and ruptured discs

The jelly-doughnut-like discs of tissues that separate your vertebrae from one another tend to deteriorate with age and overuse. If your disc ruptures or tears, the tissue can press against adjacent nerves, causing extreme pain that can radiate down your legs, a condition known as sciatica.

Your doctor may recommend an ESS procedure called endoscopic discectomy to remove damaged tissue and seal the ruptured disc. On the day of your surgery, you lie face down on the table. We administer a local anesthetic to keep you comfortable and pain-free.

After making a small incision, your doctor inserts a metal dilator to keep the site open. They then insert the endoscope to visualize the treatment site in high-def and real time.

Through the same channel, they insert tiny instruments to remove damaged disc tissue and other debris. They ablate adjacent nerves that could be causing pain. They also repair and seal the tears in the disc with laser energy to prevent further rupture and irritation.

Advantages of ESS

Unlike conventional open surgery, ESS procedures require very small incisions that only need a suture or two to close and heal. You bleed less with ESS, which speeds up your recovery time.

Because you only require local anesthesia, you avoid the potential complications and long recovery time that come with general anesthesia too. You also have less pain with ESS, which means you’ll need fewer and less potent painkillers. 

If you have back pain or sciatica due to a slipped disc or facet joint nerve pain, call us at 833-774-6327 to make an appointment today. Or, book an appointment online with our convenient form.