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Technique Offers Outpatient Surgery On Spine
By Marvin Ellis Staff Writer
Tyler Morning Telegraph

A one-stitch, Band-Aid outpatient endoscopic surgical procedure for lumbar spine problems has been performed at Mother Frances Hospital, one of 25 hospitals using this new equipment.

"Micro endoscopic discectomy is minimally invasive spinal surgery that will be especially beneficial for cases involving a painful ruptured disc in the lower back," Tyler neurosurgeon Guy O. Danielson III said.

"It offers new hope for patients who suffer from sciatica, a painful, chronic back condition that is characterized by shooting and recurrent pain in the lower back that often radiates to the hips and legs," he said.

A ruptured disc is caused by some type of injury or trauma. "The outer cover of the disc is torn and the soft central portion, the soft-grisly part found between the vertebrae, has been pushed out, adding pressure to the spinal nerves and causing extreme pain," he said. Equipment for endoscopic lumbar spine surgery has been difficult to develop he said. "With previous minimal invasive low back surgery, because the area is so small where we work, technology has not been available for most cases. But with the recent developments with improved optics, cameras and lighting, we have been able to utilize this procedure in more cases.

He said the camera is connected to a television monitor to allow the surgeon to watch what areas he needs to cut, drill and remove parts of the vertebrae and the disc.

"Well be able to perform surgery on a much higher percentage of patients who suffer from a rupture disc. To date, only 10 percent of these patients were candidates for the older endoscopic surgery. With this new technology and our improved techniques, 70 to 80 percent of these patients will be candidates for this advanced surgical techniques," he said.

He said he performs about 150 surgeries on ruptured discs, and with this new procedure we should be able to increase the number.

Danielson said compared to standard open disc surgery, MED involves much less soft tissue dissection. "Instead of incising the muscles and reflecting them from the spine, as in standard surgery, with MED the muscles are separated between their fibers, and, as the endoscope is removed, the separated muscle fibers reapproximate."

Danielson says the new endoscope system, which took more than three years to develop, is much better, and has more applications than any endoscopic equipment that has come before it, due to better optics and lighting.

"Since this is a less invasive surgery where the incision is less than ½ inch, the patient can recover more quickly. In fact, we've advanced to the point that the only post-operative dressing necessary with this surgery is one stitch and a Band-Aid, mostly on an outpatient basis," Danielson said.

He said this surgery generally has less pain and helps the patient recover faster, thus returning to work sooner in many cases.

Traditional disc surgery required a 1 to 1 ½-inch incision, with hospital stays for one to two days.

Danielson has been working with the manufacturer, Sofamor Danek of Memphis for more than three years in the design and development of endoscopes for use in spine surgery.

Steven M. Foster, director of Marketing for Sofamor Danek, said, "Dr. Danielson has been very involved in the evolution of our endoscopic program, from both a technological and clinical standpoint. He has provided a great deal of feedback and has also helped train some of our original surgeons in the new procedure."

This new endoscope is currently available to only 25 hospitals where doctors have been trained, but as this procedure is learned by other neurosurgeons, it is expected to grow throughout the United States. Mother Frances was among the first 10 hospitals using the technique due to Danielson working with Sofamor Danek in the development stages.

Danielson said, "Thankfully, we've created a better endoscope that has broader applications, that will make less invasive spine surgery available to more people. It will make a significant impact on how surgery is performed in the future."

Neurosurgeon Charles R. Gordon worked with Danielson on the project during development the past three years. Two of the endoscopic surgical procedures have been performed at Mother Frances, with a third one scheduled Monday.

   
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