Our Summary

This research paper discusses a type of spine surgery known as Full Endoscopic Spinal Surgery (FESS). This surgery is considered as the least invasive among current spinal surgeries and can be used to perform various procedures on the spine with minimal damage to the spinal structure. One unique aspect of this surgery is the use of continuous saline irrigation, a process likened to “underwater surgery”. However, for neurosurgeons, mastering this technique can be challenging due to the steep learning curve involved with using a small diameter endoscope for the surgery. The paper then goes on to explain the indications and surgical procedures of the transforaminal approach, a method of reaching the spine, and introduces decompression by FESS at the cervical (neck) spine level as well as a procedure called full endoscopic lateral lumbar interbody fusion.

FAQs

  1. What is Full Endoscopic Spinal Surgery (FESS) and what procedures can it be used for?
  2. How does FESS differ from conventional spinal surgeries?
  3. What is the learning curve like for neurosurgeons who are learning FESS procedures?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal surgery is to follow all post-operative instructions carefully, including proper wound care, medication management, and physical therapy exercises. It’s important to give your body time to heal and not rush back into normal activities too quickly. Make sure to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support your recovery and overall spinal health.

Suitable For

Patients who may be recommended for spinal surgery include those with conditions such as herniated discs, spinal stenosis, spinal deformities, spondylolisthesis, spinal fractures, tumors, and infections. These patients may have symptoms such as severe back or neck pain, radiating pain or numbness in the arms or legs, weakness, difficulty walking, or loss of bowel or bladder control. The decision to recommend spinal surgery is typically made after conservative treatments such as physical therapy, medications, and injections have not provided adequate relief. It is important for patients to discuss their symptoms and treatment options with a spine specialist to determine if surgery is the best course of action for their specific condition.

Timeline

  • Pre-surgery: The patient will typically undergo a series of diagnostic tests, such as X-rays, MRI, and CT scans, to determine the extent of the spinal issue and the best course of treatment. They will also meet with their surgeon to discuss the procedure, potential risks, and expected outcomes. Pre-operative instructions will be given, including fasting guidelines and medication adjustments.

  • Day of surgery: The patient will arrive at the hospital or surgical center and go through the pre-operative preparations, such as changing into a hospital gown and having an IV line inserted. They will meet with the anesthesiologist to discuss anesthesia options. The surgery will be performed, typically taking several hours, depending on the complexity of the procedure.

  • Post-surgery: The patient will wake up in the recovery room and may experience some pain and discomfort. Pain medication will be administered as needed. They will be monitored closely for any complications, such as infection or excessive bleeding. Physical therapy may be initiated soon after surgery to help with mobility and strength. The patient will be discharged from the hospital once they are stable and able to manage their pain at home.

  • Recovery: The patient will follow a post-operative care plan, which may include restrictions on certain activities, physical therapy, and follow-up appointments with their surgeon. It may take several weeks to months for the patient to fully recover and return to normal activities, depending on the type of surgery and individual healing process. The surgeon will monitor the patient’s progress and make any necessary adjustments to their treatment plan.

What to Ask Your Doctor

  1. What specific type of spinal surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with the surgery?
  3. What is the expected outcome and recovery time for this surgery?
  4. How experienced are you in performing this type of surgery?
  5. Are there any alternative treatments or surgical options available?
  6. Will I need physical therapy or rehabilitation after the surgery?
  7. How long will I need to stay in the hospital after the surgery?
  8. What type of anesthesia will be used during the surgery?
  9. How will the surgery affect my daily activities and quality of life after recovery?
  10. What should I do to prepare for the surgery and what are the post-operative care instructions?

Reference

Authors: Nishimura Y, Lübbers T, Kitayama M, Yoshimura M, Hattori G. Journal: No Shinkei Geka. 2021 Nov;49(6):1124-1135. doi: 10.11477/mf.1436204500. PMID: 34879333