Full-endoscopic spinal surgery is a modern and safe alternative to conventional spinal surgery. The most popular endoscopic procedures involve removing bulging, herniated or sequestrated disc material from the spinal canal in treating sciatic and femoral neuralgia or lower limb paresis. The second most common procedure is performed for constrictions of the spinal canal (stenosis), which cause weakness and pain in the lower limbs, lumbar pains, neurogenic claudication (weakness in lower limbs after walking a short distance), numbness and reduced sensation in the feet or the entire limbs.

Procedures in full-endoscopic spinal surgery are performed through a 5-mm endoscope working channel under saline irrigation. Using saline pressure and tools which eliminate bleeding in radio frequencies significantly reduces scarring and increases visibility. With endoscopes we can reach spinal pathologies even at very deep levels and make them fully visible thanks to xenon lighting, high-powered magnification and wide field of vision with optical instruments positioned at an angle of 25 degrees.

Endoscopic surgery has a number of unique advantages over other techniques. Here are some of them:

The endoscope is small in diameter and placing it under X-ray control directly into the involved level of the spine significantly reduces trauma that is associated with every surgery. Reducing injury to the minimum means fewer changes in the immune system, lower influence on immunity and less adverse effect on the cardiovascular system and the whole body. This results in quicker recovery and return to active life.

Thanks to endoscopy we can reach the spine within minutes even in very obese patients. The duration of the surgery and general anaesthesia is much shorter due to the use of a working channel, placed under X-ray control. This improves patient experience.

The pressure of saline solution used in the procedure and a new system for bleeding control lowers blood loss to absolute minimum even in very extensive endoscopic spinal surgeries.

Good visibility of nerves lowers the risk of their injury and reduces the number of potential complications caused by damage to the dura mater, bleeding or infections.

The narrow working channel causes much less injury to the lumbar area muscles, speeding up the recovery process and significantly reducing postoperative pain. The post-operative pain caused by endoscopic surgery is usually controlled with small doses of paracetamol.

Using a high-speed drill to obtain bone access reduces postoperative pain.

The above technological advantages of the full endoscopic access in spine surgery bring the following benefits to the patient:

• shorter hospital stay – up to 12 hours when optimal conditions are met,
• reduced risk of developing complications,
• significantly less pain related to the surgery itself,
• the patient gets up immediately after awakening from anaesthesia which reduces complications due to prolonged lying in bed – this is especially important for elderly patients,
• the procedure can be performed on elderly patients suffering from other diseases that would disqualify them from conventional treatment,
• shorter recovery and quicker return to work.

Surgery without the use of microscope or endoscope requires much wider access to the spine to provide sufficient visibility and illuminate the operated structures. This requires a larger incision, even over 10 cm in length in some cases, leading to a much larger wound. With the use of endoscopic techniques the same procedure would only require a 5 mm incision.

Classic discectomy involves:

• extensive incision,
• marked decrease in immunity,
• significant infection risk, including neuroinfections,
• significant risk associated with poor wound healing,
• liquorrhoea, which requires long rest,
• significant blood loss,
• damage and scarring of spinal muscles causing chronic lumbar pain,
• intra-articular fractures caused by traditional bone forceps, another cause of postoperative pain,
• delay in assuming an upright posture,
• increased risk of damage to neural structures due to lack of magnification and proper lighting, which may lead to paresis and dysaesthesia.

Conventional discectomy means:

• long treatment,
• increased health risk,
• severe pain caused by the surgery.

We do not operate this way.