Spinal Endoscopy is a procedure used to diagnose and treat the causes of chronic low back pain and radiculopathy. Using an instrument called a flexible fiberoptic endoscope and steerable guiding catheter, the physician is able to visually inspect anatomical structures, tissues and nerves inside the epidural space.
How does spinal endoscopy work?
Often, the body in its natural attempt to heal from injury or surgery will develop tissue which will encase nerve roots. These adhesions may cause irritation and inflammation, potentially resulting in severe and chronic pain.
Adhesions are very difficult to visualize with standard MRI or CT scans. During the initial clinical trials of the spinal endoscope, physicians discovered that many patients examined by MRI or CT scan often had adhesion that went undetected. Spinal endoscopy confirmed the presence of adhesive tissue in these same patients. Today, physicians often treat chronic low back pain and radiculopathy by injecting medication into the epidural space with a needle and syringe. Unfortunately, injected medication will frequently flow away from the encased and inflamed nerve roots. As a result, relief may be temporary or not at all.
Spinal endoscopy is a relatively simple procedure that is performed in a hospital or surgical center on an outpatient basis. After receiving some mild sedation, the physician will inject a local anesthetic into the lower part of your back. The physician then introduces the steerable catheter and fiberoptic endoscope into the epidural space. The catheter and endoscope are carefully advances to the area of suspected pain. You may feel some pain as the instruments move close to the inflamed nerve. In fact, the physician may replicate your pain and ask if this is the type of pain you usually feel. Using a combined technique of catheter movement and irrigation, the physician can separate many of the adhesions encasing the nerve roots. This allows the physician to directly see the inflamed nerve root, its texture, color and severity of inflammation, The physician can then place medication directly onto the irritated nerve root. After the procedure, you are sent to the recovery room for a short period of time, then released to go home.
What are the side effects of spinal endoscopy?
As with any invasive procedure, you may experience some side effects. Side effects may include: burning or tingling during the procedure, headache during and following the procedure, pain at the site of spinal endoscope insertion for a few days, and small amounts of drainage from the site of spinal endoscope insertion.
How do I know if I am eligible for spinal endoscopy?
Spinal endoscopy is not for everyone and not everyone can benefit from the procedure. Your physician can determine you eligibility after performing a thorough history and physical examination. You are probably a candidate for spinal endoscopy if your back pain radiates to the legs (this is called radiculopathy) and you have failed other less invasive or conservative therapies or surgery. You are less likely to be a candidate if you have other serious diseases or psychiatric/ psychological disorders.
Are there special instructions I need to follow at home?
Activities: After the procedure go home and rest. It is vital that someone drive you home from the hospital or surgery center. Do not drive a motor vehicle, operate machinery or make important decisions for 24 hours. When sitting or resting, changing positions frequently may help reduce stiffness and soreness. The following day you may resume normal activities providing you listen to you body. Rule of thumb: If it hurts, don’t do it. Be cautious and do not push yourself.
Medications: You doctor may prescribe some medication for pain. If you are taking medication do not drink alcohol. The combination could be lethal.
Unusual Symptoms: It is important to report any unusual symptoms to you doctor. These include but are not limited to: fever, nausea, vomiting, headache, persistent pain and excessive drainage at the insertion site.
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