Spinal Endoscopy

Spinal endoscopy is a procedure used to diagnose the causes of chronic radicular back pain. Using an instrument called a flexible fiberoptic endoscope and steerable video guide catheter, your doctor can visually inspect your epidural space and determine why you are having pain.

I already had an MRI. Is Spinal Endoscopy any different?

MRI, CAT scans and myelograms are all good diagnostic tools; however, they do not always give a clear picture of the problem. For example, many people suffer from chronic low back pain because scar tissue or adhesions have formed in the epidural space. Scar tissue and adhesions are usually the result of the body's natural tendency to heal itself after surgery or injury. Scar tissue can actually encapsulate or surround nerve roots, causing inflammation and irritation. The resulting pain is usually severe and may extend from the back to the legs.

The MRI, CAT scan and myelogram are unable to accurately etect scar tissue or adhesions. Furthermore, these diagnostic tools provide the physician with only a black and white "snapshot" of the epidural space.

Using a spinal endoscopy the doctor can examine the entire epidural space. He will be able to see inflamed nerve roots and the color, texture and severity of diseased tissue directly on a TV screen.

Will the doctor be able to treat my pain?

Your doctor may be able to separate much of the scar surrounding the inflamed nerve roots, which will allow medications to reach the nerve roots directly.

Where will the procedure be performed?

Spinal Endoscopy is performed in the ambulatory surgery center procedure room. It is done on an outpatient basis which means you will go home within a few hours.

What happens during the procedure?

An intravenous line will be inserted in your arm and you will lie on the procedure table face down. Although you must remain awake for the procedure you will receive medication to sedate and relax you. The doctor will inject a local anesthetic in the lower part of you back. The doctor will then insert a needle to locate the epidural space. A small plastic tube called a cannula is placed in the epidural space. Once in the epidural space, the doctor will slowly advance the fiberoptic spinal endoscope to locate the area causing pain. You may feel some pain as the endoscope moves close to the inflamed nerves. In fact, the doctor may replicate your pain and ask you if this is the type of pain you usually experience. At this time the doctor may chose to render appropriate treatment.

During the procedure, a nurse will be monitoring your blood pressure, heart rate and oxygen level to make sure you are tolerating the procedure well. After the procedure you will be observed in the office for approximately 60 minutes.

How long will it take to feel relief?

Some patients experience a decrease in pain almost immediately. However this is usually temporary It can take up to 36 hours for the medication to take effect. In fact, you may experience some increased pain during this time. Once the medication starts working you may experience further relief.

Are there any instructions I need to follow at home?

Activities: You will probably have soreness at the site the endoscope was inserted. Two or three times a day take a warm shower (not a bath!) with a towel wrapped around the painful area. If this is not effective, apply an ice pack wrapped in a light towel to the painful area. However, do not use ice longer than 10 minutes at a time.

After the procedure go home and rest. When sitting or resting, changing positions frequently may help reduce stiffness and soreness. The following day you may resume normal activities providing you listen to your body and do not push yourself. Your body will tell you have active or inactive to be. Remember the rule of thumb: "If it hurts don't do it." Also, do not drive a motor vehicle, operate heavy machinery or make important decisions for 24 hours.

You may begin to feel significantly better after several days Be cautious and do not push yourself. Increase you level of activity slowly, allowing time for your muscles to get stronger.

Diet: There are no restrictions on the food you eat. Since it is important not to strain while having a bowel movement eat foods that are high in fiber and eliminate those foods which may cause constipation. If necessary, you may want to use a mild laxative for a few days.

Medications: Your doctor may prescribe some medications for pain. If you are taking medication do not drink alcohol. The combination could be lethal.

Remember: Report any unusual symptoms to your doctor, especially fever, nausea, vomiting, headache, persistent pain, and excessive drainage at the insertion site.