Full Endoscopic Spinal Surgery for Spinal Stenosis
Recent population studies show spinal stenosis is at least 3 times more common than previously thought. Depending on the severity, it affects between 14-40% of patients over the age of 60. Patients, with severe spinal stenosis, are more than 3 times at risk to suffer back pain, usually in conjunction with hip or leg pain. The pain limits both mobility and the enjoyment of regular activities. The 2 options for many of these patients were prolonged episodes of debilitating discomfort or the prospect of major surgery with no guaranteed results.
The most common cause for spinal surgery in patients over 60, spinal stenosis is caused by bone spurs, scar tissue, or the onslaught of arthritis changing the normal cylinder-shaped spinal canal and accompanying nerves to take the shape of an hour glass at the point of nerve compression. Spinal stenosis operations have increased more rapidly than any other type of lower back surgery in the last thirty years. Nationally, 1 out of 5 stenosis patients (with no further medical complications) still undergo fusion operations. If this sounds like a lot, it is. From 2002-2007, there was a 15-fold increase in the fusion surgery with no documentation of improved outcomes.
Despite the lack of evidence of proven relief, fusion patients face twice the risk of life-threatening surgical complications, readmission to the hospital, or death than with endoscopic solutions. The majority of patients with uncomplicated spinal stenosis don’t need fusion operations. They may be successfully treated with current full-endoscopic spinal surgery on an outpatient basis, under local anesthesia and mild sedation. Our patients never have fusions, hospitalizations, or complications associated with major surgery. It is a huge step in facilitating a speedy recovery.
1 Ruetten S, Komp M, Merk H, Godolias G., Surgical treatment for lateral recess stenosis with the full-endoscopic interlaminar approach versus conventional microsurgical technique: a prospective, randomized, controlled study. J. Neurosurg Spine 10:476-485, 2009
2 Kalichman L, Cole R, Kim D, Ling L, Suri P, Guermazi A, Hunter D., Spinal stenosis prevalence and association with symptoms: the Framingham Study. Spine Journal 9:545-550, 2009
3 Deyo RA, Mirza SK, et.al. Trends, Major Medical Complications, and Charges Associated With Surgery for Lumbar Spinal Stenosis in Older Adults. JAMA 303:1259, 2010