Transforaminal Endoscopy

Often referred to by surgeons as the Tessys method, osteopathic specialists use the technique for treating herniated or prolapsed discs in the lumbar spine. Discs lying between the vertebrae consist of a tough, fibrous outer cartilage shell. The interior of the disc has a gel-like substance that acts as a shock absorber. Physical stress or the natural aging process may create a weakened area along the edge of the disc that allows the soft gel to ooze from within the shell. As the disc displaces, vertebrae also shift, which may inflame or compress spinal nerves and cause discomfort. Transforaminal endoscopic surgery corrects the problem.

Benefits of Transforaminal Endoscopic Surgery

Unlike major surgeries requiring that patients undergo general anesthesia, surgeons perform TES procedures using local anesthesia and mild sedatives. With patients awake and alert, surgeons more easily determine and manage a patient’s pain level. While stabilizing the spine, TES procedures merely require a small incision measuring approximately eight millimeters in length.

The smaller incision reduces blood loss, causes a reduced amount of tissue trauma and produces minimal scarring. Patients typically recover faster and return to previous lifestyles within a shorter period of time. The newer technique also benefits patients having a history of back surgery.

Transforaminal Endoscopic Surgery Procedure

Depending on the surgeon performing the procedure, patients may lie on their stomach or on their left side. After administering a sedative and local anesthesia, the surgeon makes a small incision on the patient’s right side. A rotating X-ray like device hovers over the patient or moves along the opposite side, which provides the surgeon with internal visualization and ensures proper placement of instrumentation.

After making the incision, the surgeon inserts a guide wire to the desired location on the spine over the affected disc. Using the fluoroscope image for reference, the surgeon then inserts dilators through the tunnel created by the wire, which gradually increases the surgical opening and creates a tunnel to the appropriate destination. Through the tube-like dilator, the physician inserts a fiber optic camera along with the necessary instrumentation.

While viewing the image displayed by the fiber optic camera the surgeon inserts tiny forceps that cuts and removes the herniated disc without traumatizing any surrounding tissue. Following disc removal, the surgeon evaluates the position of nerve fibers and ensures that the location no longer exhibits signs of compression. The surgeon closes the incision with one or two dissolvable stitches and covers the site with a small, sterile dressing.

The patient then goes to a recovery room where medical staff assess discomfort levels, the surgical site and vital signs. Within an hour following the surgery, the patient stands and walks while under medical supervision. Patients generally leave the facility around two hours after undergoing surgery and return to normal activities according to the surgeon’s instructions.