Endoscopic spine surgery (ESS)

Are you a candidate for spinal surgery using the endoscopic technique?

Common spinal conditions that may be an indication for endoscopic spine surgery include so-called disc disease, moderate or severe intervertebral disc herniation, facet arthropathy, recurrent sciatica as well as spinal canal stenosis.
Spinal disease must be diagnosed not only on the basis of the patient’s history and clinical examination, but also confirmed by diagnostic imaging (MRI, CT scan).
However, it should be emphasized that spine surgery should not always be the first course of treatment. As a rule, it is recommended that other types of non-surgical treatment (drug therapy and rehabilitation), be tried before any type of surgical treatment of the spine, including endoscopic spine surgery.

How is endoscopic spine surgery performed?

The endoscopic procedure is generally performed under local anesthesia or analgosedation. After being placed on the operating table, the patient is prepared for the procedure, with a local anesthetic administered to block pain. Through a skin incision under scopic control, a so-called working trocar, or rigid tube, is inserted into the operated area. Access to the spine, depending on the patient’s specific diagnosis and the doctor’s choice of technique, can be through the so-called intralaminar access (from the back of the spine between two plates) or transforaminal access (transforaminal from the back/lateral side of the spine).
A thin endoscope ending in a tiny camera is then inserted through the trocar into the targeted area of the spine undergoing surgery. Through the endoscope, microsurgical instruments are inserted with which the surgeon operates. Throughout the endoscopic operation, the camera captures and displays real-time, very high quality images of the operated area on a monitor, watched by the surgeon. The endoscopic camera with visualization of the surgical field assists the surgeon during the operation, and when the operation is complete, all instruments, the camera and the endoscope with the trocar are gently removed. The skin incision is sutured and a small dressing is applied.

How does endoscopic spine surgery work?

Endoscopic minimally invasive spine surgery is performed using a general or local anaesthetic. In both cases, you will not feel any pain as the treated area will be completely numb.

The first step of the procedure consists of making a 15-millimetre incision and introducing an endoscope. A dilator will be used to keep the incision open. This will allow the surgeon to see live images of the inside of the spinal canal. The main objective of the procedure is to try to remove the herniated vertebral disc tissue with the help of forceps. This is performed from the inside of the herniated disc, so the risk of damaging the spinal cord is drastically reduced. This will help relieve any compressed nerves. In addition, with this technique, it is possible to introduce medication more directly, as it’s easier to reach the areas where pain is located. At the end of the procedure, all instruments are removed and the incision closed.

The duration of an endoscopic minimally invasive spine surgery is typically between 30 minutes and 1 hour.

How do you prepare for endoscopic spine surgery?

If you think endoscopic spine surgery might help or if your doctor has suggested this procedure, get in touch with us. One of our patient coordinators will get back to you to ask you questions about your current health and explain how the procedure works in detail. In order to assess your eligibility for endoscopic spine surgery, you will need to send us an MRI or CT scan of your spine, performed within the last 6 months. Make sure you pack your test results with you when you visit our clinic, including the CD. The test description alone is not sufficient.

You will be informed whether you need to perform other medical tests; this will be assessed by our neurosurgeon, Dr. Stanisław Kwiek, who will also perform the procedure. Once you’re admitted to KCM Clinic, you will also have an anesthesiological consultation. You will most likely stay at our clinic for two days. Please also consider that you won’t be able to drive a car for some time after surgery. We offer pick-ups and drop-offs to and from the airport to all our international patients to make your experience on site as worry-free as possible!

Post-surgery: How’s recovery like after endoscopic spine surgery?

Usually, the patient is admitted in the morning, and during the same morning the operation is performed. The next day, the patient can go home wearing a lumbar corset.

Overall, recovery is faster than with traditional spine surgery. You should be able to go back to your life as soon as you leave the clinic. Painkillers may be prescribed to treat initial pain and discomfort. Make sure you observe how your body responds to surgery. While most patients feel better right after the procedure, always be careful and share any doubts you might have with your doctor.

Also remember to avoid any strenuous activity or heavy lifting for about 6 weeks after the procedure. Then, you can resume your regular workout routine.

Right after surgery, you will be recommended physiotherapy and rehabilitation, a very important step after this type of surgery! At KCM Clinic, you will be followed by Dr. Krzysztof Suszyński, a specialist in physiotherapy, who will supervise your physiotherapeutic treatment before and after the procedure.