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Endoscopic spinal surgery (ESS) is a type of minimally invasive surgery (MIS) performed using an endoscope. An endoscope is a thin tube with a camera and light at the end which allows your surgeon to visualise the specific area of the spine.
Endoscopic spinal surgery uses a small incision of only a few millimetres and the use of an endoscope for visualisation. The result is minimal disturbance of the surrounding tissues and structures of your spine, meaning less bleeding, faster recovery times and a quicker return to everyday life.
Endoscopic spinal surgery is a highly specialised technique that is more technically demanding than traditional open spine surgery, meaning surgeons must undergo rigorous training before they are qualified to offer this procedure.
Endoscopic surgery explained by an expert
Mr Ankur Saxena, consultant neurosurgeon at The Alexandra Hospital in Manchester, is one of the UK's foremost endoscopic spinal surgeons and an accredited national trainer of the technique.
He explains, "Endoscopic surgery is in a bigger bracket of minimally invasive surgery. It is the least invasive because it causes minimal destruction of the muscle. You tackle the pathology in a similar way as you would do with open surgery, except that the approach causes the least collateral damage."
Endoscopic spinal surgery can be performed to treat several common conditions that cause back pain.
Endoscopic spinal surgery is used is to treat lumbar disc prolapse, often referred to as a herniated disc, which is one of the most common causes of lower back pain. The procedure can also be used to treat other causes of lower back pain, such as spinal stenosis.
Herniated disc (slipped disc)
Your spinal discs are soft areas of tissue that act as cushions between your back bones (vertebrae), which are the bones in your spine. A herniated disc, commonly known as a slipped disc, means one of these has moved from its correct position. If this happens, the jelly-like substance that makes up the inside of the disc can start to protrude against the tough, fibrous ring. This can put pressure on nearby spinal nerves, causing pain and irritation.
Spinal stenosis
Spinal stenosis is the narrowing of the spinal canal, which houses your spinal cord and nerves. When the spinal canal becomes constricted due to age or arthritis, it puts pressure on your spinal nerves, causing lower back pain and sciatica (burning, tingling or numbness in the buttocks and down the legs).
Preparing for minimally invasive spinal surgery
Before surgery, your consultant will discuss all the risks and benefits of the procedure with you. They will advise on any steps that need to be taken before the surgery such as stopping smoking or temporarily stopping non-essential medications.
Endoscopic surgery is unusual in that it can be performed using local anaesthetic as well as general anaesthetic. This means that spinal surgery can be performed on people who have other health issues where a general anaesthetic may be dangerous for them.
During the procedure
During the procedure, the surgeon will make a small incision of only a few millimetres in your back that allows them to access the affected area of your spine. Using state-of-the-art specialised tools, the surrounding tissue is gently moved, and the affected area of your spine is treated.
The endoscopic camera is used to guide and assist the surgeon throughout the procedure. The camera's images are projected in real-time onto a monitor, allowing the surgeon to visualise what they are doing. After the surgeon has resolved the disc prolapse or spinal stenosis, they remove all instruments and stitch up the wound, which needs just one or two stitches.
Most ESS procedures are completed in around an hour. After the surgery, you should be able to get up and move around within hours. Depending on your individual condition, you may even be discharged and able to go home on the same day.
Spinal surgery is only recommended as a last resort after painkillers, rest, injections, and physiotherapy have not worked. Endoscopic spinal surgery might be recommended or those people who have not found relief from other therapies.
Due to general anaesthetic not being necessary, endoscopic spinal surgery can be performed on people of all ages.
Endoscopic spinal surgery is the least invasive surgical technique and offers multiple benefits, including:
- Less soft tissue damage and less scar formation
- Less blood loss
- Minimal risk of infection
- No need for general anaesthesia
- No disturbance to the stabilising structures of your spine (muscles, ligaments, and bones)
- Decreased post-operative pain and discomfort
- Shorter stay in hospital
- Quicker return to everyday activities
Mr Saxena explains, "What the endoscopic techniques help you with is faster recovery and less risk of early complications. In a year's time, if I do an endoscopic surgery or an open surgery, the eventual outcomes for both patients will be very similar. But the endoscopic spine surgery patient would have a faster recovery and less risk of early complications."
When you go private with us, you can expect:
- Flexible appointment times and locations to fit your routine
- The freedom to choose which hospital and consultant suit your needs
- Personalised, consultant-led treatment plans tailored to you
- Comfortable and safe private facilities maintained by expert multidisciplinary teams
- Private ensuite rooms as standard and delicious healthy meals
- Affordable, fixed-price packages with aftercare included
- Flexible payment options to help you spread the cost of your care
At Circle Health Group, our friendly team is always on hand to provide information, advice and reassurance. If you're experiencing back pain or spinal problems and would like more information about possible treatment options, you can book an appointment online or give us a call directly.
Content reviewed by Circle in-house team in October 2023. Next review due October 2026.
