Cervical Endoscopic Spine Surgery

Cervical endoscopic spine surgery is performed to treat conditions such as:

• Herniated cervical discs – CESS can remove the herniated portion of the disc, relieving pressure on the nerve roots
• Cervical spinal stenosis – CESS can help by removing the structures causing the narrowing such as bone spurs and thickened ligaments
• Degenerative disc disease – CESS can address the symptoms by removing the problematic disc material and alleviate nerve compression.
• Bone spurs – Bone spurs can develop on the cervical vertebrae leading to nerve compression. These bone spurs can be removed through CESS.
• Cervical radiculopathy – This is compression or irritation of the cervical nerve roots. CESS can relieve pressure on the affected nerves, reducing pain and other symptoms.
• Foraminal stenosis- This is the narrowing of the foramina, the openings through which the spinal nerves exit the spinal column, which can compress nerves. CESS can enlarge these openings to reduce nerve compression.
• Disc protrusion- similar to herniated discs, disc protrusion involves the displacement of the disc materials which can press on the nerves. CESS can remove the protruding material to alleviate symptoms.
• Failed previous surgery – sometimes patients can have persistent or recurrent symptoms after previous spinal surgery. CESS can be used as revision surgery to address these issues with minimal invasiveness.

Cervical endoscopic spine surgery offers a less invasive option compared to traditional open surgery, with the potential for quicker recovery and reduced postoperative pain. However, not all patients are candidates for this type of surgery, and the decision to proceed with endoscopic surgery depends on the specific condition, its severity, and the patient’s overall health.

The procedure is performed under general anesthesia or local anesthesia with sedation. A small incision, usually less than an inch, is made over the target area. The endoscope and all surgical instruments are inserted through the incision, providing a clear view of the spinal structures on a monitor. Specialized surgical instruments are passed through the endoscope to remove or repair the problematic tissue. This may involve removing a portion of the herniated disc, bone spurs, or other structures compressing the nerves. Once the procedure is completed, the instruments and endoscope are removed, and the incision is closed with sutures or surgical tape.

The advantages of this minimally invasive approach include:

• Smaller incisions lead to less bleeding during surgery.
• The technique avoids extensive muscle dissection, preserving muscle function.
• Patients typically experience quicker recovery times and shorter hospital stays compared to traditional open surgery.
• Smaller incisions and less tissue damage result in less postoperative pain.

The success rate of cervical endoscopic spine surgery is high, with many studies reporting success rates between 80% to 95%. Success is typically defined as significant relief of pain and improvement in function. Factors influencing the success rate include the patient’s overall health, the severity of the spinal condition, and adherence to postoperative care and rehabilitation protocols.

Fortunately, risks such as bleeding, infection, or persistent pain are quite rare. The main concern with endoscopy is its thoroughness and the learning curve associated with the technique. Thus, it is important to select a surgeon such as Dr. Colman with significant experience with this and other techniques.