What Are the Different Types of Endoscopic Spine Procedures?

Blog Summary:

• Endoscopic spine surgery (ESS) is an ultra-minimally-invasive technique used to treat a variety of spinal conditions like herniated discs, stenosis, and facet joint pain. 

• ESS is not one specific procedure, but a surgical method that uses a small camera (endoscope) for precise, muscle-sparing access to the spine. 

• Four of the most common types of endoscopic spine procedures, all of which are performed at Desert Spine, include transforaminal decompression, interlaminar decompression, foraminotomy, and endoscopic rhizotomy. 

• Each procedure targets specific causes of nerve compression or joint pain with less tissue disruption and faster recovery than open surgery. 

• Endoscopic techniques are shown to provide lasting relief—even years later—for patients who haven't improved with conservative care. 

If you’ve read any of our previous blog posts, then you probably have heard quite a bit about endoscopic spine surgery (ESS) and its many benefits. Even if you haven’t, chances are you will find yourself here because a clinician or friend has suggested that you may be a candidate for ESS.

But what exactly is ESS? It’s not one specific type of procedure! Rather, it’s an ultra-minimally-invasive approach to surgery of the cervical and lumbar spine.

Now, you might be asking yourself, “Well, what kind of spine surgeries can be performed endoscopically?”. That is precisely the question we aim to answer.

At Desert Spine and Scoliosis Center, our expert team is well-versed in a variety of endoscopic back surgeries for conditions ranging from herniated discs and spinal stenosis to painful facet joints.

What is an Endoscopic Spine Procedure?

An endoscopic spine procedure is technically any spine procedure performed endoscopically. Endoscopic spine surgery, or ESS, is, further, classified as a subtype of minimally invasive spine surgery (MISS) since it’s actually an ultra-minimally-invasive intervention.

This can be confusing for those experiencing back, neck, or nerve pain who’ve been pointed towards ESS as a potential treatment, because it’s actually not a singular treatment so much as a way of performing different treatments for varying spine conditions.

Endoscopic spinal procedures make use of a small camera called an endoscope to provide an HD view of the spine, allowing the surgeon to remove bone spurs, disc material, or even painful nerve tissue with minimal disruption to nearby muscles and nerves.

What Are the Main Types of Endoscopic Spine Surgery?

Various types of spine surgery can be performed either endoscopically or via alternate means. The main four types of ESS we perform at Desert Spine and Scoliosis Center, so chosen because they also happen to be among the most effective and in general, are:

1. Endoscopic Transforaminal Spinal Decompression 

This type of endoscopic spine surgery is performed through the foramen. It can be very effective for patients with severe leg or back pain caused by spinal or foraminal stenosis who haven’t improved with physical therapy or pain management.

Studies show that endoscopic transforaminal spinal decompression provides lasting relief and better function even 10 years later, despite aging, other health issues, or past back surgeries.” 

2. Endoscopic Interlaminar Spinal Decompression

The interlaminar approach enters through the space between the lamina (the back part of the vertebra) to relieve pressure on pinched nerves. It can be extremely helpful for patients with spinal stenosis, which often causes back pain, leg weakness, and trouble walking.

Compared to open surgery, interlaminar endoscopic procedures cause less tissue damage, blood loss, and pain leading to faster recovery. Studies show they provide long-term relief and improved function even 10 years after surgery, making them an excellent option for patients who don’t respond to conservative treatments.

3. Endoscopic Foraminotomy

A foraminotomy is performed when the nerve root exits have narrowed (foraminal stenosis) and need to be widened. Using an endoscope, the surgeon performing an endoscopic foraminotomy carefully removes bone or disc material to enlarge the foramen and, by extension, relieve nerve compression.

This procedure is commonly used to treat radiating arm or leg pain that hasn’t responded to conservative treatment.

4. Endoscopic Surgical Rhizotomy (Facet Medial Branch Nerve Transection)

For patients experiencing chronic facet joint pain that hasn’t responded to injections or other conservative care, an endoscopic rhizotomy can provide lasting relief.

In this procedure, the surgeon uses a camera-guided endoscope to precisely identify and ablate (cut or cauterize) the tiny nerve branches the medial branch of the dorsal ramus that carry pain signals from the facet joints.

Unlike traditional radiofrequency ablation guided only by X-ray, the endoscopic approach allows the surgeon to directly view the problem nerves. This improves accuracy and makes results more consistent while making the procedure ultra-minimally-invasive.

Clinical studies show that patients treated with endoscopic rhizotomy often achieve greater pain relief and improved function compared to conventional techniques. In fact, many continue to experience relief for over a year, and some avoid the need for more invasive fusion surgery.

Should I Consider Endoscopic Spine Surgery? 

Wondering if one of the above types of ESS is right for you? The best way to find out is to have an spine surgeon who’s experienced in performing endoscopic spine procedures like Dr. Baig perform a comprehensive medical evaluation.

Get in touch with us today for an initial consultation or to learn more! 

FAQs About Endoscopic Spine Surgery

What are the approaches to endoscopic spine surgery? 

The two main approaches are transforaminal (through the nerve exit) and interlaminar (between the lamina). Both allow access with minimal muscle disruption, depending on where the compression is. 

What is the latest technology in spine surgery?

Advances include robotic-assisted surgery, biologic bone grafts, and expanded endoscopic spine surgery procedures that replace more invasive open operations. 

What is the best way to sleep with degenerative disc disease?

Most patients find relief sleeping on their back with a pillow under the knees, or on the side with a pillow between the legs, to keep the spine aligned and reduce pressure.