“An important consideration for anyone doing endoscopic surgery is how to ablate tissue and create hemostasis. Not all methods are created equal and I have found over the last 15 plus years that elliquence’s technology is trustworthy and performs better than other RF machines, allowing me to achieve better results. elliquence technology cleanly and efficiently ablates the tissue while controlling hemostasis very effectively, and as a result is a key component in excellent patient outcomes.… Read more

The interlaminar window at L5-S1 is easily accessed through a direct posterior approach, visualized using both AP and Lateral radiographs. The lateral facet is located and the stab incision is made directly medial to the facet to the level of the fascial layer. The dilator is introduced to the level of the ligamentum flavum, confirming AP and Lateral radiographs. The cannula is introduced over the dilator with the bevel open medially and the endoscope is introduced. Various instruments including… Read more

Patient selection is critical to the success of any surgical approach, the herniated disc tissue must be accessible through the foramen. Patient is positioned in the prone position on either bolsters or a Wilson frame to open up the foraminal space. AP and Lateral radiographs are used to identify the targeted foraminal levels. If an intra-discal approach is elected, an 18 gauge spinal needle is initially introduced not past the medial edge of the pedicle AP view, and in the posterior 3rd of the … Read more

Endoscopic Dorsal Ramus Rhizotomy is a procedure that can provide patients with relief of pain associated with degenerative disease of the facet joints. Use of the spine endoscope provides visualization of the posterior spinal anatomy and nerves, while an endoscopic RF probe facilitates the ablation of the medial (and lateral) branches of the dorsal ramus and can lead to more complete ablation of the nerves and therefore better and longer lasting pain relief. Endoscopic Rhizotomy is most effecti… Read more

Lumbar spinal stenosis is a common cause of radicular and generalized back pain among older adults. Endoscopic minimally invasive surgery, in contrast to open decompression, may provide the opportunity for a less invasive surgical intervention. Visualization and illumination during the operation can be optimized. Since a more extensive bone or ligament resection is frequently necessary here, a larger diameter endoscope with a correspondingly larger endoscopic working channel and larger instrumen… Read more