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Drew Albert

June 14, 2025

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. 

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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

Where can I find more information? 

  • Arthrex recently launched ArthrexEndoscopicSpine.com, a patient education resource dedicated to highlighting the benefits of endoscopic spine surgery. The site allows patients to explore ultra-minimally invasive treatment options designed to restore function, preserve motion, and minimize pain.

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. 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
  4. Lewandrowski KU, Ransom NA, Yeung A. Return to work and recovery time analysis after outpatient endoscopic lumbar transforaminal decompression surgery. J Spine Surg. 2020;6(Suppl 1):S100-S115. doi:10.21037/jss.2019.10.01 
  5. 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
  6. Sairyo K, Matsuura T, Higashino K, et al. Percutaneous endoscopic lumbar discectomy for athletes. J Spine. 2013;S5(006):1-4. doi:10.4172/2165-7939.S5-006
  7. Sivakanthan S, Williams JR, Feroze AH, et al. Endoscopic spine surgery in athletes: case series and review of literature. World Neurosurg. 2021;145:702-707. doi:10.1016/j.wneu.2020.08.211 
  8. Gadjradj PS, Broulikova HM, van Dongen JM, et al. Cost-effectiveness of full endoscopic versus open discectomy for sciatica. Br J Sports Med. Published online February 20, 2022. doi:10.1136/bjsports-2021-104808
  9. Page PS, Ammanuel SG, Josiah DT. Evaluation of endoscopic versus open lumbar discectomy: a multi-center retrospective review utilizing the American College of Surgeons’ National Surgical Quality Improvement Program (ACS-NSQIP) database. Cureus. 2022;14(5):e25202. doi:10.7759/cureus.25202
  10. Du R, Gao J, Wang B, et al. Percutaneous radiofrequency ablation and endoscopic neurotomy for lumbar facet joint syndrome: are they good enough? Eur Spine J. 2024;33(2):463-473. doi:10.1007/s00586-023-08078-5
  11. Siddiqi F, Romero J, O’Donnel C, Hayes V. Five year long-term results of endoscopic dorsal ramus rhizotomy and anatomic variations of the painful lumbar facet joint. Paper presented at: Society for Minimally Invasive Spine Surgery Annual Conference. November 1-3, 2013; Las Vegas, NV. 
  12. 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

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