Endoscopic Spine Surgery Vis-à-vis Open Spine Surgery

Back pain is one of the most common causes of disability worldwide. An alarming 60 % of the people in India have suffered from low back pain at some point in their life. The majority of these patients are women in the age group of 30 to 40 years. More than one in three adults say back pain impacts everyday activities, including sleep.

This results in a significant loss of work hours worldwide. The most common cause of back pain that needs surgery is disc herniation associated with sciatica. After exhausting all forms of conservative treatments for back pain, the traditional spine procedure performed was an open spine surgery resulting in further significant morbidity.

The latest technique called endoscopic discectomy allows the treatment of a damaged disc more safely and in a more tissue-preserving way than ever. Through clear visualization, the nerves that travel through the spinal canal remain completely untouched and hence complications are avoided. Even the intervertebral ligaments that help in stabilizing the spinal column also stay intact.

How is the Endoscopic Discectomy performed?

Most of the times the procedure is done under local anesthesia which means that the patient is awake during the surgery and can interact with the doctor.It is performed using a high precision endoscope which helps in proper visualization of each and every affected structure in the spine. This can be called a targeted surgery because only the affected portion of the disc is removed while preserving most of the healthy disc. The procedure takes about an hour and the surgery wound is so small that it is closed with a band-aid. The patient is allowed to walk on the same day and is encouraged to get back to work at the earliest.

Advantages of Endoscopic Spine Procedure Over traditional Open Spine Surgery

In the international scientific literature success rates of about 90% are quoted for endoscopic spine procedures. The advantages include:

  • The Endoscopic procedure is usually done under local anesthesia in a cooperative patient while the traditional open surgery requires complete general anesthesia.
  • The incision size in an endoscopic procedure is about 6-7 mm while in an open surgery it is about a few cms.
  • The blood loss in an endoscopic procedure is almost negligible when compared to an open surgery
  • There is less tissue damage and recovery is much faster in endoscopic surgery when compared to regular open spine surgery.
  • Not much pain medication is required and fewer antibiotics are needed after the surgery in an endoscopic procedure when compared to open surgery.
  • Hospital stay is about 1 day on an average for endoscopic spine surgery while it is about 3 days for an open spine procedure.
  • As per the available literature, the recurrence rate in the endoscopic technique is about 4  % while in an open spine surgery it is about 7

By Dr Vishnu Manyam, Consultant – Spine Surgeon, Gleneagles Global Hospital

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