Dr. Frank Schwab being interviewed by FOX Health

Spinal surgery has undergone a significant technological evolution over the past decade. In addition to new spinal fusion devices and spinal instrumentation, the surgical techniques of spinal surgery have been transformed. In recent years, developments in video and minimally invasive surgical instruments have spurred a variety of endoscopic surgical procedures. These procedures have identical goals to traditional surgery but make use of an endoscope (like a telescope which permits peering into the body through a small incision) thereby minimizing the size of skin and muscle incisions.

Although endoscopic surgery has been applied in general surgical procedures for several years, this technique has only recently been applied to the treatment of spinal disorders. A number of leading teams have pursued research into endoscopic spinal surgery in order to bring this technique into the clinical arena. Through collaboration with other medical specialties and extensive laboratory work, the safety and efficacy of thoracoscopic spinal surgery (endoscopic surgery on the thoracic spine) has been established.

We are now at the point where endoscopic techniques for spinal surgery are applied in the operating room with remarkable success. Some of the first cases have involved adolescents with scoliosis. In difficult cases of scoliosis the spinal column is deformed and rigid. In order to obtain a correction of these deformities a surgery to the front and the back of the spinal column is necessary. Traditional surgery requires a large incision (6 to 10 inches) in the chest area and removal of one or more ribs in order to gain access to the front of the spine. Thoracoscopic surgery involves making several small (1 inch) incisions and using the endoscope to visualize the spine on a TV monitor. Specialized instruments are then used to carefully operate on the spine through the small incisions.

With traditional open front and back spinal surgery patients with rigid deformities would spend about I week in the hospital. Applying new endoscopic techniques a reduction in hospital stay and greater patient satisfaction can be seen. There is less pain in the recovery period and much smaller scars from the surgical incisions. As the experience and research evolves with endoscopic surgery, an increasing number of patients will benefit from these less aggressive techniques which leave small scars, decrease operative blood loss, and permit a rapid post-operative recovery. Aside from surgery for scoliosis, the endoscopic techniques can be applied in the treatment of kyphosis, infection and tumors.