What is Sciatica?

It's not a disease, it's a symptoms where patient experiences radiating pain from lower back to one or both the legs. It may be associated with tingling and numbness. Patient may experience this pain as patchy distribution in lower back, thigh, leg and in ankle foot region. Sciatica comes from some kind of nerve inflammation with or without compression.

What is a Slipped disc?

Slipped disc is a term commonly used for disc herniation. Disc Herniation can occur anywhere in the spinal column of the human body starting from C2 to Sacrum as there is one disc in between every two vertebrae.

What is EndoSpine360?

It's a concept & philosophy of 360 degree endoscopic spinal decompression which can be done by different endoscopic approaches including interlaminar & transforaminal access to epidural space of spinal canal.

What is Spine Endoscopy?

Endoscopy means magnified & illuminated visualization of structures inside the human body hence it is minimally invasive surgical technique. Spine Endoscopy means endoscopic visualization with camera & light source to see the nerves & spinal cord by inserting the endoscope in the epidural space commonly used for decompression of spinal cord & nerves with minimal disruption to surrounding tissues.

What is Transforaminal Endoscopic Spine Surgery?

When the spine surgeon approaches spinal nerves or the spinal cord through the neural foramina, its called as Transforaminal Endoscopic Spine Surgery.

What is Interlaminar Endoscopic Spine Surgery?

When the spine surgeon approaches spinal nerves or the spinal cord through the interlaminar window, its called as Interlaminar Endoscopic Spine Surgery.

Can Endoscopic Spine Surgery be done for all types of slipped disc cases?

Yes, Experienced endoscopic spine surgeons can manage all types of disc herniation by endoscopic spine surgery with the currently available advanced techniques and tools.

Can stenosis be operated by Endoscopic Spine Surgery?

Yes, Spinal stenosis can be managed by endoscopic spine surgery. Your surgeon may select either transforaminal or Interlaminar or both endoscopic approaches to deal with stenosis.

What is full endoscopic spine surgery?

“Full Endoscopic” means all the operating instruments also pass through the working channel of the endoscope itself instead of passing them through different working channel hence it is also called as uniportal endoscopic spine surgery. There are now many endoscopic or endoscopic assisted procedures available for spine surgery but full endoscopic spine surgery is the most minimally invasive option available in the world.

What is minimally invasive endoscopic surgery?

Minimally invasive spine surgery is also called as keyhole surgery. The word MIS is commonly used for spine surgery done by tubular retractor system.

Can we do endoscopic spine surgery under LA?

Yes, we can do endoscopic spine surgery under local anesthesia. Transforaminal endoscopic spine surgery is commonly done under local anesthesia because patient needs to be awake and aware during the surgery. Patient can himself or herself can perform neuro monitoring during the procedure by checking ankle and foot movements.

Can we go for a spine endoscopic surgery after a revision surgery?

Yes endoscopic spine surgery can very well be done as revision surgery. As we have got different endoscopic approaches available, we can select the new approach which was not used during the first surgery. Operating with the same approach is also possible with some challenges.

What could be the minimum age for a spine endoscopic surgery?

As the currently available Spine endoscopes have got minimum cannula size of 7.9 to 8mm we need to have patients with height of more than 4.5 feet for safe Transforaminal endoscopic spine surgery and minimum age group for transforaminal approach should be 12 years of age whereas for interlaminar endoscopic spine surgery minimum age group could be even less than 12 years.

How safe is spine endoscopic surgery?

Endoscopic spine surgery is very safe as it is very much precise. The skin incision is 8 to 10 mm. This procedure is being done commonly under local anaesthesia and sometimes under epidural analgesia. Hence even patients who are high risk for general anaesthesia can also opt for endoscopic spine surgery.

What could be the minimum number of days a patient has to be hospitalized for a spine endoscopic surgery?

Endoscopic spine surgery is now a day care spine procedure. Patient can go home on the day of surgery.

How many types of spine endoscopic surgeries are there?

Endoscopic spine surgeries can be done for lumbar, thoracic and even for Cervical spinal pathologies. Lumbar endoscopic spine surgeries are commonly being done across the world. Endoscopic lumbar & thoracic spine surgeries can be done by interlaminar or trans foraminal approach. Cervical endoscopic spine surgery can be done by posterior or anterior approach.

Can we do fusion surgery through endoscopic spine surgery?

Yes, full endoscopic as well as endoscopic assisted fusion procedures are now commonly been done across the globe.

How long it takes for an endoscopic spine surgery to be done?

Commonly a single level endoscopic spines surgery takes one and half to 2 hours including anaesthesia and the procedure time.

After how many days of endoscopic spine surgery can we involved in our daily activities?

After the endoscopic spine surgery one can walk, sit. & stand on the same day of surgery. But you will be advised to take special precaution in terms of bending forward, lifting weights, doing any floor level activities and any kind of activities increasing the abdominal pressure like coughing sneezing constipation. One must avoid the food which can cause gaseous distension of the abdomen.

Who did the first endoscopic spine surgery in central India?

Dr. Prasad Patgaonkar

How should I select my Spine Surgeon?

Your Spine surgeon must be a fellowship trained Orthopaedic or Neurosurgeon. He or she should be trained in endoscopic spine surgery as well as spinal pain management. The surgeon who has got all the possible options (Interventional pain management, endoscopic spine surgery, Minimally Invasive spine surgery as well as open spine surgery) in his armamentarium to deal with your spinal pathology will be the best doctor to offer you the best possible treatment for your Pathology . The surgeon should be managing the patient as per the clinical and radiological condition of the patient.

Does endoscopic spine surgery have any scarring?

The scars of endoscopic spine surgery are usually 8 to 10 mm in size. They are very cosmetic as they heal almost without any scarring and they are almost invisible after 6 months to 1 years.

What could be the maximum age for endoscopic spine surgery?

There is no age limit for endoscopic spine surgery as transforaminal endoscopic spine surgery can even be done under local anaesthesia having the only prerequisite that the patient needs to lie prone on his chest for minimum 1 to 2 hours.

Which one is better: an open spine surgery or an endoscopic spine surgery?

A well trained endoscopic spine surgeon will be the best judge to select open versus endoscopic spines surgery. wherever endoscopic spic surgery is possible. endoscopic spine procedure will always be the better option as compared to open having its obvious advantages of minimal skin incision, better anaesthesia care, magnified illuminated vision for better precision and safety, faster recovery, minimal Hospital stay and early return to work.

Is endoscopic surgery a better for cervical spine surgery also?

Yes, endoscopic spine surgery is being done even for cervical spine all over the world. Posterior cervical endoscopic spine surgery is indicated for foraminal herniations and anterior cervical endoscopic discectomy and fusion procedures are being done for Central herniations as well as compressive myelopathy.

Does a patient suffer from any kind of pain in the process of endoscopic spine surgery?

As the endoscopic procedure is done under local and epidural analgesia patient usually gets the needle pricking pain during the procedure of analgesia and anaesthesia. If the patient is anxious and apprehensive, posterior inter laminar endoscopic procedures can also be done under general anaesthesia.

Do we have any alternate option for an endoscopic spine surgery?

90% of the patients with disc herniation and stenosis are being treated with alternate therapies. These are only those 10% of the patients, not responding to non operative management, actually need endoscopic spine procedure . Surgeons not trained in endoscopic spine surgery, may opt for other MIS minimally invasive surgery or open procedures.

Whom to select as Endoscopic Spine Surgeon?

Endoscopic spine surgery was started by Orthopedic spine surgeons hence you will find most of the endoscopic spine surgeons are Orthopedic spine surgeons who are fellowship trained endoscopic spine surgeons. Now with increasing demand and evolution of subspeciality branches, well trained Neurosurgeons and even Pain physicians also perform endoscopic spine procedures.

What conditions can be treated with endoscopic spine surgery?

Endoscopic spine surgery can be used to treat a range of spinal conditions, including herniated discs, spinal stenosis, bone spurs, spinal tumors, spinal infections, and spinal instability. It is particularly effective for conditions that cause nerve compression or spinal cord compression.

How is endoscopic spine surgery performed?

During endoscopic spine surgery, the surgeon makes one or more small incisions, typically less than an inch in length. The endoscope is then inserted through the incision, allowing the surgeon to visualize the affected area on a monitor. Specialized instruments are used to remove or repair the damaged or problematic tissue. The procedure may be performed under general anesthesia or local anesthesia with sedation.

Who is a candidate for endoscopic spine surgery?

The suitability of endoscopic spine surgery depends on several factors, including the specific spinal condition, its severity, and the patient's overall health. It is best to consult with a spine specialist or a surgeon experienced in endoscopic techniques to determine if you are a suitable candidate.

What are the potential risks and complications associated with endoscopic spine surgery?

Endoscopic spine surgery is generally considered safe, but like any surgical procedure, it carries some risks. Potential complications may include infection, bleeding, nerve damage, spinal fluid leak, blood vessel injury, or anesthesia-related risks. However, the risk of complications is typically lower compared to traditional open surgeries. It is important to discuss the potential risks and benefits with your surgeon before deciding on the procedure.

Are the results of endoscopic spine surgery long-lasting?

Endoscopic spine surgery can provide long-lasting relief for many spinal conditions, particularly when used to address nerve or spinal cord compression. However, the success of the procedure depends on various factors, such as the underlying condition, patient compliance with post-operative care, and individual healing abilities. Some conditions may require additional treatments or follow-up procedures to achieve optimal outcomes.

Is endoscopic spine surgery covered by insurance?

Insurance coverage for endoscopic spine surgery can vary depending on the insurance provider and the specific policy. It is recommended to contact your insurance company to determine the coverage details and any pre-authorization requirements. Your surgeon's office can also assist in verifying insurance coverage and working with the insurance company to obtain approval if necessary.

How can I find a qualified surgeon for endoscopic spine surgery?

When seeking a surgeon for endoscopic spine surgery, it is important to look for a specialist who has experience and expertise in minimally invasive spine procedures. You can start by asking for referrals from your primary care physician or seeking recommendations from trusted healthcare professionals. Research the surgeon's qualifications, training, and experience, and consider scheduling a consultation to discuss your specific case and ask any questions you may have.

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