Patients suffering from a pinched nerve in the neck now have an ultra-minimally invasive surgical option: cervical endoscopic spine surgery. This advanced surgical technique can provide relief for patients suffering from pain, numbness and/or weakness radiating down the shoulder and arm. When compared to traditional methods, cervical endoscopic spine surgery produces less pain and a rapid recovery.

“Endoscopic spine surgery is performed through an incision that is approximately eight millimeters, less than a centimeter, in length,” says Peter Derman, M.D., a spine surgeon on the medical staff at Texas Health Center for Diagnostics and Surgery. “But the beauty of endoscopic surgical techniques is not just the small incision. It’s what happens under the skin that makes a dramatic difference.”

What is Cervical Endoscopic Spine Surgery?

Cervical endoscopic spine surgery is often used to treat pinched nerves and is the newest and least invasive level of surgical spine techniques.

“There's a whole spectrum of surgical techniques from the traditional spine surgery to minimally invasive techniques, which involve a smaller incision and less muscle damage,” explains Dr. Derman. “The next iteration is endoscopic surgery, or ultra-minimally invasive surgery, which uses a camera through an extremely small incision. By making that leap where we’re using a camera, rather than looking at the spine with our eyes or with a microscope, we make an even smaller incisions, which means less tissue damage. For the patient, it means an even quicker recovery.”

An Alternative to Traditional Surgery

Until the development of minimally invasive techniques, spine surgery was exclusively performed as "open surgery." The area being operated on was opened with a long incision to allow the surgeon to view and access the spine. One of the drawbacks to traditional spine surgery is a surgeon detaches the muscles around the spine and then moves them to the side in order to access the spine and underlying issues. This produces damage to the muscle and other surrounding soft tissues. As a result, patients often experienced more pain from the surgery itself. Traditional surgery also required a lengthier recovery period and posed a higher risk of infection and blood loss.

While many surgeons still perform open surgery, technological advances have allowed specialized surgeons to treat more back and neck conditions with minimally invasive, and now ultra-minimally invasive, surgical techniques.

“These techniques can be applied to anywhere in the spine – the low back, the midback, and the neck,” says Dr. Derman. “The common thread between all of them is that they use smaller incisions and cause less muscle damage.”

For many patients, endoscopic techniques also allow surgeons to precisely target the problem area, eliminating the need for spinal fusion – a procedure where surgeons connect two adjacent vertebrae to help eliminate pain.

“Fusion has some disadvantages: it’s a longer procedure, usually involves a longer recovery, and it eliminates motion in the area of the spine where the procedure is performed,” says Dr. Derman. “I’ve been able to perform many outpatient, endoscopic, non-fusion surgeries on people who would've otherwise required a fusion. These patients were able to get up and get moving right away, and they didn’t lose any of the motion that they had.”

Choosing Cervical Endoscopic Spine Surgery

Cervical endoscopic spine surgery is performed while the patient is under anesthesia and usually takes an hour to 1.5 hours. The surgery is performed on an outpatient basis, in contrast to the 1-2 day hospital stay that traditional surgery may require.

“Most patients go home the same day after surgery,” Dr. Derman says. “Very little pain medication is necessary; in fact, I often have patients who just take Tylenol. Patients can be active as soon as they feel comfortable doing so.”

Regardless of operative technique, surgery is usually recommended only if nonsurgical treatments - such as medications and physical therapy - do not relieve the painful symptoms. A spine surgeon on the medical staff at a Texas Health hospital can help weigh your surgical options and determine the most appropriate care approach for you.

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