Endoscopic Spine Surgery

Endoscopic spine surgery is a minimally invasive surgical technique that uses a small camera (called an endoscope, hence the name) and specialized instruments inserted through tiny incisions to access and treat spinal conditions such as herniated discs and nerve compression. Relative to more traditional surgery approaches, it further minimizes damage to muscles and surrounding tissue, often resulting in less postoperative pain, lower risk of infection, quicker recovery, and shorter hospital stays. This advanced approach is relatively new and continues to evolve, offering a highly precise and less disruptive alternative for many patients needing treatment for their spine pain and/or condition. OrthoNebraska is the first in the state of Nebraska to offer this approach to its patients.

Endoscopic spine surgery is best suited for patients with specific spinal conditions that have not responded to conservative treatments like physical therapy, medications, or injections. Ideal candidates typically have herniated discs, sciatica, or foraminal narrowing that is causing persistent back or leg pain due to nerve compression. It is often a good option for patients who desire a minimally invasive alternative to open surgery, especially those who may benefit from faster recovery and less tissue disruption.

However, it’s not appropriate for every case. Patients with severe spinal instability, advanced deformities, or widespread degenerative disease may require more traditional or extensive surgical approaches. A thorough evaluation by a spine specialist typically includes imaging and clinical assessment to help determine if endoscopic spine surgery is the right fit. At OrthoNebraska, we create treatment plans in partnership with our patients so that we can meet their goals, and we welcome patients asking about this innovative approach and if it is right for them.

Endoscopic spine surgery has demonstrated success rates comparable to, and in some cases better than, traditional open or minimally invasive spine surgery—particularly for well-selected patients. For common procedures like lumbar discectomy (removal of herniated disc material), studies show success rates ranging from 85% to 95%, which is on par with traditional microdiscectomy.

Compared to traditional open surgery, endoscopic approaches typically (but not always) result in:

• Smaller incisions, smaller scars and less tissue disruption
• Reduced infection and complication rates
• Fewer or no narcotic pain medications for pain control

However, it’s important to note that outcomes are highly dependent on proper patient selection and surgeon experience. Endoscopic spine surgery is still relatively new in many regions, and its long-term data is continuing to grow. In experienced hands, though, it offers an excellent, evidence-supported alternative for treating specific spine conditions with outcomes that rival traditional methods and often exceed them in terms of recovery experience.

You may need a pre-surgical physical to make any necessary accommodations based on your health history.

On the day of endoscopic spine surgery, the experience is typically streamlined and focused on patient comfort and safety. You will most likely be outpatient and go home the same day. After checking in, you’ll meet with your surgical team, review your consent, and be taken to pre-op where anesthesia is administered—usually light general anesthesia or monitored sedation, depending on the your case.

During the procedure itself, a small incision (usually less than 1 cm) is made in the skin over the spine. Using fluoroscopic (X-ray) guidance, the surgeon inserts a narrow tube down to the area of the spine requiring treatment. Through this tube, a high-definition endoscopic camera and specialized surgical instruments are introduced. The camera provides a magnified, real-time view of the spine on a monitor, allowing the surgeon to precisely remove disc fragments, bone spurs, or other tissue compressing the nerves—while preserving surrounding muscles and ligaments.

Once the problem is corrected, the instruments and camera are withdrawn, and the small incision is closed, usually with just a single stitch or surgical glue. The entire procedure often takes under an hour. After surgery, patients are monitored in recovery for a few hours and typically discharged the same day with post-op instructions. Most patients can walk within an hour or two and resume light activities within a few days, with full recovery over several weeks depending on the condition treated.