Minimally Invasive Spine Surgery using endoscopic - Spinal Cord Disorders Message Board

mooaa · 09-26-2005, 12:41 PM

hi everyone
i want to know if anybody tried or heard about the using endoscopic to perform Minimally Invasive Spine Surgery ?
is there any one know about the disadvantage for this kind of surgery

it is performed using a tool called an endoscope, which is a thin tube that has a tiny video camera on the end of it. The surgeon inserts the endoscope through a small cut and guides it to the problem area. Muscles are then dilated apart, rather than cut, and the operation is performed with minimal injury to any surrounding tissues. Throughout the operation, the tiny video camera on the end of the endoscope projects large-scale images of the spine .

hugo eve · 09-26-2005, 04:51 PM

Hi Mooaa

I've heard that it has a higher risk factor as there is less control and visibilty than opening someone up. If working less close to the cord it maybe worth the risk. I could see it used for trimming protusions and spurs but not for anything more major. I like the trued and tried methods even if it does cause more pain and suffering initially. It is good to see knew procedures being investigated but would rather not be the guinea pig. It seems to take decades to see if a procedure is acceptable. I'm a little bit sceptic that some surgeons do try to get kudos by being the first to impliment new procedures but that is just my opinion.

Hugz

welded C4567

notpain · 09-26-2005, 06:47 PM

The risk factor is actually much lower. If you search the web search for Dr. Jho - good information. The procedure is done under fluoroscopy (X-Rays) so the doctor can see exactly where the needle is being placed.

The procedure is performed under local anesthesia with the patient awake and in a lateral position. A small needle is inserted into the disc space after local anesthesia has been administered. Over this needle, a slightly larger probe is inserted to permit a 2mm incision to be made in the disc itself. Under x-ray and fluoroscopic control, the micro-instruments (mini forceps, mini curettes, trephines, rasps, burrs, and mini cutters), the discectome and the laser probe are used for disc removal. Very small pieces of the disc material are removed and suctioned into the tip of the discectome and then cut by its knife. The laser is used for further removal of the disc and for further shrinkage, for the purpose of disc decompression. The procedure takes about 30 minutes to an hour, on the average. X-ray exposures are minimal.The amount of disc removed and shrinkage by the laser varies, but includes the herniated portion. The supporting structure of the disc is not affected. Upon completion, the needle is removed and a small Band-Aid is applied over the needle incision.

You are awake during this proceedure (but fortunately still sedated). This hurts! But it is better than disc pain/problems. I have had two proceedures under Guided Fluoroscopy and will probably have a third and/or fourth. There is no muscle disection or bone removal (except in Jho's proceedure where a small hole is drilled for access). You can walk and move around the same day! Just very cautiously. And activites can be resumed in 1 to 6 weeks. Contrast this to fusion where the muscles are cut, and there is bone scraping (My term) and fitting of the bone graft (plus possible hip pain from an allograft - patients own bone). This is an "minimally invasive" proceedure. The only real disadvantage is you may not be a good candidate.

Other proceedures to consider are IDET (Annuloplasty) where a Thermal Catheter is threaded through a needle into your disc and heated. This is minimally invasive but has a much longer recovery time as it takes a while for the disc to heal from the proceedure.

Nucleoplasty - channels are made in the disc with a Perc-D spine wand also threaded through a needle.

There is always a risk of infection. And the surgery is only as good as the surgeon. But this is much safer than fusion and retains your own disc material. For many this could be the answer. It's much cheaper than full blown fusion as well.

There are more than 30 possible treatments for neck problems - 3 Minimally invasive that I know of- here are more. Educate yourself s much as you can - it's time consuming but well worth the effort. And trust and read as much as you can the experience of others. I would never have fusion having read all I have on here - that is until it is the absolute last option - then my never will go to an "okay lets just do it". Funny thing how pain can change your course of thought.

These are NOT new proceedures, these are tested and FDA approved. Even artificial discs are not NEW proceedures, they are just very slow to develop in the USA. I'd do Endoscopic surgery before fusion and/or artifical discs any day.

http://www.healthsynergyrx.com/neck-pain.htm

Preapproved by moderator1

saabstress · 11-23-2005, 12:25 PM

I've seen one orthopod, who gave me hospital admission papers for ACDF the day I saw him to hear my MRI results, one neurosurgeon who agreed that I had stenosis at C4-5 and blown discs (and recommended ACDF) and one neurosurgeon who likes posterior laminectomies and told me I didn't have any issues (he actually told me my symptoms were "BS"). Don't want a plate and screws with ACDF. I shipped my films off to Dr. Jho and I'm now on the waiting list for the minimally invasive procedure:-) I had considered going to Germany or Belgium before I found Jho.

jayboy557 · 12-05-2005, 02:27 PM

i had this procedure done and it made things much worse. also, i was in severe pain for a month after the procedures. i think its a percutneous or nucleoplasty discectomy your talking about. for me, it was not worth it.

i had an adr in july and it was much less painful and they even cut me on the tummy. i've heard there is a big failure rate with these minimally invasive procedures. i will never do it again. hopefully the fda will approve stacking the artificial disc on top of one another so fusions won't cause stress on the healthier discs. jason