Spine surgery has evolved significantly over the past few decades, leading to improved patient outcomes, shorter recovery times and reduced risks. Among the most significant advancements in this field are endoscopic and minimally invasive spine surgery, both of which aim to treat spinal conditions with smaller incisions, less muscle disruption and faster recovery than traditional open surgery. While these two approaches share many similarities, understanding their differences is essential for patients considering surgical treatment for their spine issues.
Minimally Invasive Spine Surgery: The Basics
Unlike traditional open surgery, which requires large incisions and significant muscle dissection, as well as increased risk of infection, minimally invasive spine surgery utilizes small incisions, specialized instruments and advanced imaging to access the spine and treat the underlying condition.
The goal of using minimally invasive techniques is to reduce the trauma to surrounding muscles and tissues, decrease the risk of complications and shorten recovery time. This type of surgery is commonly used to treat conditions like herniated discs, spinal stenosis and degenerative disc disease.
"Minimally invasive spine surgery has really transformed spine care in the past couple of decades. With minimally invasive treatment strategies, we see reduced recovery times, less post-operative pain for patients, and a quicker return to daily activities — all while maintaining the highest standards of surgical precision and outcomes."
Grant Shifflett, MD | Board-Certified Minimally Invasive & Reconstructive Spine Surgeon
An Introduction to Endoscopic Spine Surgery
Endoscopic spine surgery is a specific subset of minimally invasive spine surgery and involves the use of an endoscope — a long, flexible tube equipped with a camera and light — which allows the surgeon to view the surgical site on a monitor in real-time. The endoscope is inserted through a small incision, and the surgeon can perform the necessary procedure by navigating the surgical instruments through the endoscope.
Endoscopic surgery is typically used for conditions like herniated discs, spinal stenosis, and foraminal stenosis, which is the narrowing of the nerve exit pathways. Endoscopic spine surgeries have even smaller incisions compared to traditional minimally invasive techniques, resulting in minimal muscle dissection and potentially quicker recovery times.
“At DISC, we have really high quality arthroscopic endoscopic technology, which is imperative when we’re operating on nerves or the spinal cord. That gives us actually even higher magnification and visualization with the camera inside the spine. And so that's a relative rarity for a freestanding surgery center to have that level of technology as far as endoscopes. This level of magnification is crucial because nerves and discs are very small despite the tremendous pain that they cause,”
Joel S. Beckett, MD | Board Certified Neurological Spine Surgeon
Key Differences Between Endoscopic and Minimally Invasive Spine Surgery
While both endoscopic and minimally invasive spine surgery aim to achieve similar goals, there are notable differences between the two approaches. The primary distinctions include:
- Size of the Incision: Endoscopic procedures require even smaller incisions than minimally invasive spine surgeries, typically ranging from 1 to 2 centimeters compared to 2 to 5 centimeters. During an endoscopic spine surgery, the surgeon inserts the endoscope and surgical instruments through this tiny opening to access the spine. It’s worth noting that the incisions in minimally invasive surgeries are still much smaller than the incisions made during traditional surgeries.
- Surgical Visualization: In a minimally invasive spine surgery, surgeons often rely on specialized instruments and real-time imaging, such as fluoroscopy (a type of X-ray), to guide the surgeon. During an endoscopic procedure, the endoscope provides a live, high-definition view of the surgical area, allowing the surgeon to visualize the spine in great delta and make precise movements without directly viewing the surgical site.
- Recovery Time: Both types of surgery provide faster recovery times than traditional open surgeries, however endoscopic spine surgeries typically lead to even faster recoveries than minimally invasive spine surgeries due to the smaller incisions. Many people who undergo an endoscopic procedure can even go home the same day or the day after surgery, and patients with both techniques can resume normal activities in a few weeks.
- Level of Precision: Endoscopic spine surgeries allow the surgeons to have exceptional precision in accessing and treating the spine, which is especially helpful for conditions that require it, such as nerve decompression and disc removal. Minimally invasive spine surgeries may not need the visualization and access offered by an endoscope, but still provide improved precision compared to traditional open surgery.
- Suitability for Complex Conditions: Endoscopic surgery is best suited for specific conditions, but is less commonly used for complex spinal deformities or multi-level issues. Minimally invasive spine surgery is more versatile and can be used to treat a broader range of spinal conditions, including spinal fusion and more complex cases involving multiple vertebrae.
Benefits of Both Approaches
“Both endoscopic and minimally invasive spine surgeries have plenty of advantages over traditional surgery. With both, we see smaller incisions, less disruption to the muscles, reduced blood loss, faster recovery and a lower risk of infection. Figuring out which type of surgery to perform depends on the individual patient and their needs.”
Luke Macyszyn, MD | Board-Certified Neurosurgeon Specializing in Spinal Disorders
Endoscopic and minimally invasive spine surgeries are both groundbreaking techniques that offer significant advantages over traditional open surgery. While they share common goals — minimizing patient trauma, improving recovery time, and enhancing surgical precision — each technique has its own unique set of benefits. Endoscopic spine surgery excels in providing high-precision results through very small incisions, while minimally invasive spine surgery covers a broader range of conditions and offers flexibility in treating more complex cases.
Ultimately, the choice between endoscopic and minimally invasive spine surgery depends on the nature of the condition being treated, the surgeon’s expertise, and the patient's overall health. Set up a consultation with one of DISC’s leading spine surgeons today to get help making an informed decision that aligns with your specific needs and lifestyle.