What is endoscopic spine surgery?
This approach uses a camera and specialised instruments to work through a small access point. It may allow treatment of selected disc herniations and spinal stenosis, depending on the location and characteristics of the condition.
Uniportal endoscopy
The camera and instruments share a single access. Instruments pass through the working channel of the endoscope.
Biportal endoscopy
Two separate accesses are used: one for the camera and another for instruments. This is also known as UBE or BESS.
Choosing the approach
I assess both options according to the lesion, its location and the purpose of surgery. The number of accesses alone does not determine which technique is most appropriate for you.
Which conditions may be treated
A disc herniation occurs when part of a disc protrudes and may compress a nerve root. Stenosis is narrowing of the space through which nerve structures pass. In selected cases, endoscopy allows treatment of that compression. Its suitability depends on the anatomy and the extent of treatment needed.
Symptoms that guide the assessment
Pain travelling down a leg or into an arm, tingling, weakness or limited walking ability may warrant assessment. We need to establish which symptoms relate to the lesion: back pain has different causes and does not always respond to the same treatment.
How I assess whether it suits your case
I review where the compression is and whether it explains your symptoms. The indication also depends on your examination, the course of the condition, previous treatments and spinal stability. Endoscopy is one option among the available surgical techniques.
Choosing between endoscopy and other options
First we decide whether an operation is needed. Then we consider which approach can achieve its aim with an appropriate balance of benefit and risk. Depending on the case, options may include endoscopy, microsurgery or another approach. We may also agree to continue non-surgical treatment and review progress.
What we discuss before deciding
We discuss the purpose of decompression, alternatives and risks, including infection, nerve injury, cerebrospinal fluid leakage and recurrent disc herniation. Recovery and return to activity are planned individually.
Recovery and follow-up
Before surgery, we discuss what may change in pain, sensation or strength, and what may take longer or not recover fully. Discharge, mobilisation, wound care and return to work are planned according to the operation and your progress. Follow-up visits allow us to adjust advice and address questions.
