Minimally Invasive Endoscopic Spine Surgery in India

Endoscopic spine surgery, has shown 56% reduced hidden blood loss compared to traditional open surgery

Endoscopic spine surgeries involve smaller incisions, causing less disruption to surrounding tissues compared to traditional open surgeries. This can result in reduced postoperative pain, shorter hospital stays, and faster recovery times. 

It allows for targeted access to the affected area, minimizing the need for extensive muscle dissection. This leads to reduced muscle damage, preserving muscle function and potentially improving patient outcomes. 

It often involves the preservation of spinal stability structures, such as the facet joints ( joint connecting each bone in the vertebra)  This can help maintain the natural biomechanics of the spine, reducing the risk of postoperative instability and the need for additional stabilization procedures.

Let us now understand in detail about endoscopic spine surgeries. 

What is endoscopic spine surgery? 

Endoscopic spine surgery is a minimally invasive procedure that uses a small camera called an endoscope to visualize and treat spinal conditions. It involves making small incisions and inserting specialized instruments through these incisions to perform the surgery. 

Here is a step-by-step overview of the endoscopic spine surgery procedure.

What are the steps involved in endoscopic spine surgery? 

There should be certain precautions which are needed to be taken care of before the surgical procedure. 

1. Precautions 

1. Medical evaluation

It is important to undergo a comprehensive medical evaluation before the surgery. This evaluation may involve blood tests, imaging scans, and other diagnostic procedures to assess your overall health and suitability for the procedure.

2. Medication review 

Provide your surgeon with a complete list of medications you are currently taking, including prescription drugs, over-the-counter medications, and any supplements. Some medications may need to be adjusted or temporarily stopped before surgery to reduce the risk of complications.

3.  Reduce Smoking 

If you are a smoker, it is strongly recommended that you quit smoking prior to surgery. Smoking can impair the healing process and increase the risk of complications. Talk to your healthcare provider about smoking cessation strategies.

4. Blood-thinning medications 

If you are taking blood-thinning medications, such as aspirin or anticoagulants, your surgeon may advise you to stop or adjust the dosage before surgery. This is to reduce the risk of excessive bleeding during the procedure.

2. Patient positioning and anesthesia 

The patient is positioned on the operating table in a way that allows access to the affected area of the spine. General anesthesia or local anesthesia with sedation is administered to ensure the patient’s comfort throughout the procedure.

C. Incision and dilation 

A small incision, typically less than an inch, is made in the skin over the affected area of the spine. Through this incision, a series of dilators are inserted to gently separate the surrounding muscles and create a pathway to the spine.

D. Endoscope insertion 

Once the dilation is complete, a specialized endoscope, which is a thin tube with a light and camera at the tip, is inserted through the incision and guided to the target area of the spine. The camera allows the surgeon to visualize the spine on a monitor.

E. Visualization and surgical access 

The surgeon uses the endoscope to visualize the structures of the spine, including the spinal discs, nerves, and surrounding tissues. This real-time visualization helps the surgeon accurately identify the source of the problem.

F. Tissue removal or repair 

Using specialized surgical instruments inserted through additional small incisions or working channels in the endoscope, the surgeon can remove or repair the affected tissues. This may involve removing herniated discs, trimming bone spurs, or repairing damaged tissues.

G. Closure 

Once the necessary surgical interventions are completed, the instruments and endoscope are removed, and the incisions are closed with sutures or adhesive strips. In some cases, the incisions may be so small that they do not require any closure.

H. Recovery 

After the surgery, the patient is taken to a recovery area to be monitored for a period of time. Pain management medications may be provided, and the patient will be given instructions on postoperative care, including physical activity restrictions, wound care, and follow-up appointments.

Complications of Endoscopic Spine Surgery 

Complications of Endoscopic Spine Surgery can include:

1. Dural tears 

Dural tears, or tears in the protective covering of the spinal cord, can occur during endoscopic spine surgery. This can lead to cerebrospinal fluid leakage and may require additional treatment or repair.

2. Infection 

While the risk of infection is generally low, there is still a potential for infection at the surgical site. Proper sterile techniques and postoperative care can help minimize this risk.

3. Bleeding 

Bleeding during or after surgery is a possible complication. Surgeons take precautions to minimize bleeding during the procedure, but in some cases, additional intervention may be required to control bleeding.

4. Nerve damage

 Nerve damage can occur during endoscopic spine surgery, leading to sensory or motor deficits. Surgeons take great care to avoid nerve injury, but it can still happen in some cases.

5. Incomplete decompression

Inadequate decompression of the affected spinal structures is a potential complication. This can occur if the surgeon is unable to fully remove the source of compression, leading to persistent symptoms or the need for further intervention.

6. Epidural hematoma

In rare cases, an epidural hematoma (collection of blood) may develop after surgery. This can cause compression of the spinal cord or nerves and may require urgent intervention.

Recovery from Endoscopic Spine Surgery 

The recovery from spinal endoscopy can vary depending on the specific procedure performed and individual factors. However, endoscopic spine surgery is generally associated with a faster recovery compared to traditional open surgery. 

Here are some general points about the recovery process after spinal endoscopy:

i. Hospital stay

Endoscopic spine surgery is often performed on an outpatient basis, meaning you may be able to go home on the same day as the procedure. In some cases, a short hospital stay of one or two days may be required.

ii. Pain management 

You may experience some discomfort or pain at the surgical site after the procedure. Your surgeon will prescribe pain medications to help manage any postoperative pain. It is important to follow the prescribed pain management plan and communicate with your healthcare team if you have any concerns.

iii. Activity restrictions 

Your surgeon will provide specific instructions on activity restrictions during the recovery period. You may be advised to avoid heavy lifting, strenuous activities, and bending or twisting of the spine for a certain period. Gradually, you will be able to resume normal activities based on your surgeon’s guidance.

iv. Physical therapy

Depending on the specific procedure and your individual needs, your surgeon may recommend physical therapy as part of the recovery process. Physical therapy can help improve strength, flexibility, and overall function.

v. Return to work

The time it takes to return to work after a spinal endoscopy can vary depending on factors such as the nature of your job and the extent of the surgery. Some individuals with desk jobs may be able to return to work within a couple of weeks, while others with more physically demanding jobs may require a longer recovery period.

What is the success rate of Endoscopic spine surgery in India 

The success rate of endoscopic spine surgery can vary depending on various factors such as the specific procedure performed, the individual patient’s condition, and the surgeon’s experience and skill. However, overall, endoscopic spine surgery has been shown to have high success rates in treating certain spinal conditions.

Spinal endoscopy generally indicates a high rate of success. The success rates range from 80% to 99% in terms of pain reduction, improved mobility, and patient satisfaction.

For example, a success rate of 90% or higher is reported, with HD cameras used to provide better visualization during the procedure and no need for spinal fusion. 

One study reports success rates between 60% and 97% for microdiscectomy using endoscopic techniques.

What is the cost of Endoscopic spine surgery in India 

The cost of endoscopic spine surgery in India ranges from $6,000 to $7,000 ( 4,50,000- 5,00,000 INR). These prices are significantly lower compared to developed nations like the USA, where spine decompression procedures can cost up to $30,000 ( 21,00,000 INR).

Conclusion 

Endoscopic spine surgery, specifically microendoscopic discectomy, offers the advantage of smaller incisions and potentially faster recovery times compared to traditional open surgery.

The results of endoscopic spine surgery, particularly for lumbar disc conditions, have been encouraging. Studies have reported positive outcomes and patient satisfaction with the procedure. 

MedicoExperts has a panel of neurosurgeons and orthopedics who take complete care of the patients during the surgery and also take part in extended follow-up post-surgery.

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