One of the smallest surgical footprints available for treating nerve compression in the spine — performed through a portal often smaller than a fingertip, using a slender endoscope with its own camera and light.
In endoscopic spine surgery, the operation is carried out through a narrow tube — a working channel only a few millimeters wide — rather than through the longer incision and muscle dissection of traditional open surgery. A high-definition endoscope passed through that channel carries a tiny camera and a light source to the surgical target, projecting a magnified, well-illuminated view onto a monitor. Fine instruments pass alongside the camera through the same channel.
Because the corridor is so small, the surrounding muscle and bone are spared to a degree that is generally not possible with open techniques. For appropriately selected disc and nerve-compression problems, the goal is to relieve symptoms while disturbing as little healthy tissue as possible.
The short animation below illustrates the general principles of endoscopic spine surgery for patient education.
Educational video for endoscopic spine surgery. This animation is provided for general patient education only. It is illustrative, does not depict an actual patient, and is not medical advice. Every patient and condition is different, and previous results do not guarantee future outcomes. Animation courtesy of Arthrex, used with permission for patient education. These videos are provided for patient education only and do not imply that Dr. Dimopoulos endorses, recommends, or confirms the validity of any particular product, device, or system shown.
The animation below illustrates endoscopic medial branch nerve transection, a technique aimed at interrupting the small nerve branches that can transmit pain from the facet joints of the spine.
Educational video for endoscopic medial branch transection. This animation is provided for general patient education only. It is illustrative, does not depict an actual patient, and is not medical advice. Every patient and condition is different, and previous results do not guarantee future outcomes. Animation courtesy of Arthrex, used with permission for patient education. These videos are provided for patient education only and do not imply that Dr. Dimopoulos endorses, recommends, or confirms the validity of any particular product, device, or system shown.
Every case is individualized, and the exact steps depend on your diagnosis, the level treated, and your anatomy. In general terms, an endoscopic decompression proceeds along these lines:
Your imaging is reviewed to pinpoint the exact level and side. In the operating room you are positioned and the skin is marked, often with the help of live X-ray (fluoroscopy) to confirm the target.
Depending on the case, endoscopic procedures may be performed under general anesthesia or, in selected situations, with sedation and local anesthetic. The anesthetic plan is discussed with you beforehand.
Through an incision often around a centimeter or less, a series of progressively larger dilators gently spread — rather than cut — the muscle, and a thin working tube (cannula) is placed down to the spine.
The endoscope, carrying its camera and light, is passed through the tube. Continuous saline irrigation keeps the view clear, and the magnified image is displayed on a monitor for the surgical team.
Using fine instruments under direct visualization, the source of compression — for example, herniated disc material or a thickened ligament or bone spur narrowing the nerve’s space — is carefully removed to free the affected nerve.
The nerve is checked to confirm it is decompressed. The instruments and endoscope are withdrawn, and the very small incision is typically closed with a stitch or two, often covered with a small dressing.
Because of the small access, many endoscopic procedures are performed on an outpatient basis, with patients going home the same day. Your specific recovery plan and activity guidance are reviewed with you.
Peer-reviewed sources that informed this page, provided for further reading (written for a medical audience).