Spinal Stenosis Correction

Outpatient full-endoscopic spinal surgery under local or general anesthesia.
No plates, no screws, no fusion – No kidding.

The next generation of advanced outpatient therapy for lumbar spinal stenosis is now available at Synergy Spine Center. While many centers advertise minimally invasive and endoscopic surgery for spinal stenosis, the options are not all the same. Nor have they all been proven safe and effective in rigorous, prospective, randomized, and controlled clinical trials.

Synergy Spine Center offers full endoscopic for most patients with spinal stenosis. The procedure is accomplished with a small incision (most less than 1/2 inch long) and through a lighted tube the size of pencil. Unlike other methods, this surgery is performed with continuous fluid irrigation in a bloodless surgical field. The high definition video magnification is optimal and superior to the large-tube surgical systems, which use operating microscopes or surgical magnifying glasses while the patient is under general anesthesia.

Full-endoscopic Spinal Surgery for Spinal Stenosis

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.

What to Expect

  • Patients will enter the pre-op area where vital signs are taken.
  • For those patients needing sedation, an IV will be started for the medication.
  • Patients will then enter the procedure room and lie face down on the procedural table with a pillow under the abdomen for lumbar procedures, or face up with a pillow under the head for cervical procedures.
  • Once correctly positioned, the skin overlying the site of the procedure is antiseptically cleaned and covered with sterile drapes. Local anesthesia will be injected to numb the area where the incision will be performed.
  • The doctor will endoscopically repair the area of stenosis.
  • At the completion of the procedure, the incision is closed and a Band-aid dressing is applied.

Post-Procedural Follow-up

  • Avoid being on your feet for 2-3 hours following the procedure.
  • Do not drive or operate dangerous equipment or machinery during this time.
  • Notify clinic staff if you experience prolonged pain at the surgery site, fever, chills, dizziness, or leg or arm numbness that lasts more than 2-3 hours.
  • A drop or two of blood at the incision site is normal. Contact the office if you experience persistent bleeding or drainage at the wound site.
  • Follow all instructions for further care.
  • Expect to see results from the procedure with 2-5 days. You may experience continued improvement over the next several days. Full benefit may take as long as two weeks to occur. You may use any supplemental pain medications during this time.
  • Remember, follow-up care is essential to determine the success or failure of the procedure, and to plan further care based on the results.
  • Contact Synergy Spine Center staff with any additional questions or concerns.

References:
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


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