After training under several experts from North America and Europe in endoscopic spine surgery, I am one of the few surgeons in the Virginia, Maryland, and DC region utilizing these techniques in the treatment of lumbar disc herniations and stenosis. I am fortunate to be the first spine surgeon to use certain newly released endoscopic devices in the DMV region for the treatment of stenosis. Surgical incisions can be as small as 7mm depending on the case.
My interest in minimally invasive spine surgery started out as a desire to be as precise as possible in the treatment of my patients. Many of the procedures we perform as spine surgeons are large and complex, and while surgery may improve the quality of life of our patients....sometimes, quite honestly, surgery can do quite a bit of harm as well. I often have patients who come to me with extensive back problems, but even if their MRI shows multiple disc herniations/multilevel degenerative disc disease, there might be just one level in their back thats actually causing their back/leg pain. Patients like these can sometimes end up getting multilevel spine procedures and sometimes even extensive fusions unnecessarily, when in reality they may do fine simply by targeting the one nerve that’s causing their leg pain. This is where endoscopic spine surgery is helpful.... Its like trying to hit a fly on a table with a fly swatter instead of a hammer, which may kill the fly...but also break the table.
We have used cameras/scopes in many surgical procedures: general surgery (laparoscopy), urology (cystoscopy), orthopaedics (arthroscopy for knees/hips/shoulders, etc). It was only a matter of time that technological advances would also allow us to perform these procedures in the spine as well. Interestingly, endoscopic spine surgery is commonly performed in Asia and Europe, but has only recently gained significant interest in the United States. In the next 3-5 years, I am certain that this will continue to develop and expand in the US and hopefully patients might benefit from these less invasive approaches over the longterm. Its true that endoscopic spine surgery can't treat everything in the spine, but it does offer our patients a truly minimally invasive option in the treatment of herniated discs and spinal stenosis.
One of the great things about medicine, is that we are constantly trying to figure out ways to perform procedures in a less invasive fashion. This drive towards minimally invasive surgery is patient and surgeon driven. The goal is to address the source of the pain, while doing the least amount of harm in the process.
For me, being able to perform a spine surgical procedure, with an incision 7 mm in length, and have the patient go home a few hours later is a very rewarding experience. The entire procedure is done with a camera, and patients can go home with a set of pictures as well. A few pictures from some of my cases are shown below for educational purposes.