What is NeuroEndospine Surgery?

Dr. Rappard offers the most effective minimalistic operations available for the treatment of common spinal conditions. NeuroEndospine Surgery is spinal surgery performed with a band aid incision. The term “NeuroEndospine Surgery” describes the unique aspects of this procedure. “Neuro” denotes the neurological training and expertise of the surgeon, as well as the fact that the surgeon operates in the vicinity of the delicate spinal cord and nerves. “Endospine” is a term that means “inside of the spine.” The term here means that the surgery is visualized from inside the spine, rather than through a large opening. A camera is used to visualize surgery from inside the spine, making the procedure minimally invasive.

NeuroEndospine surgery has been referred to by multiple terms. One of the most common is “endoscopic spine surgery.” In the 1990’s, endoscopic spine surgery evolved from similar endoscopic procedures being performed in the large joints. In these procedures, a surgeon places a small tube (called a cannula) into a joint and through that tube places a second tube with a lens on one end (the inside part) and a camera on the other (the outside part). This second tube with a lens and camera is called an endoscope. The endoscope could have small instruments passed through it, visualized on video via the camera. Surgeons like Parvis Kambin, Anthony Yeung and John Chiu eventually developed and refined techniques to safely place cannulas and endoscopes in the spine and used these techniques to treat back pain and nerve pain stemming from the spine. Dr. Yeung further refined these techniques and developed a method for teaching endoscopic spine surgery to surgeons. Ultimately, endoscopic spine surgery spread throughout the world, leading to further refinements in the field.

NeuroEndospine surgery is commonly referred to as “laser spine surgery.” A laser is an intense beam of light, of very high energy. In its purest form, laser spine surgery describes the application of a laser through an endoscope. The surgeon can monitor surgery on a video monitor and direct the laser fiber to decompress nerves, remove disc or bone. In endoscopic spine surgery the laser is precisely guided and visualized inside the spine via magnified video monitoring. These days, the term “laser spine surgery” tends to be applied to any type of minimally invasive spine operation, whether it utilizes a laser or not. In large part, this is a result of public awareness fueled by massive marketing campaigns. Further confusion stems from the fact that most endoscopic spine surgeons no longer use a laser. The 90’s and 2000’s brought safer and more precise tools that use radiofrequency energy instead of laser energy. These tools have advanced endoscopic spine surgery by bypassing many of the limitations of a laser.

Today, advancements in digital imaging, device miniaturization and advanced radiofrequency energy tools have allowed NeuroEndospine surgeons to treat the most common spinal conditions through band-aid incisions. Disc herniations, facet joint pain, spinal stenosis, sciatica, back pain and neck pain can be treated by an array of minimalistic NeuroEndospine procedures. Such minimalistic procedures not only allow a faster recovery in the average patient, but have also opened the door to effective out-patient spine surgery. This is true even in the most complex patients, such as athletes, geriatric (older) and bariatric (obese) patients.

Dr. Rappard performs NeuroEndospine Surgery utilizing a 3D capable heads-up display

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Testimonials

Anonymous

The guy really knows his stuff - after reviewing my imaging, we discussed possible procedures. I have done a lot of research online, and had a lot of questions. Dr. Rappard explained the different options, reviewed the pros and cons and offered me a really competitive price. Much better than flying to Arizona for some laser procedure!!

Jacob G.

I am 6 months removed from a couple of branch blocks and then 2 follow up neck procedures. I feel fine, everything is working perfectly. I was willing to accept that Dr. Rappard was a credible, and honest person from meeting with him, and thankfully I can confirm that he is a great doctor, that I recommend to anyone. To be honest, I thought the operating experience was surreal, and I was comfortable. There was a great team, that do their jobs very well, from the anesthesiologist, to the nurse.

Shari A

You saved me from a life of opiates and/or pain so strong that I couldn't perform adequately in my daily activities. After this Rhizotomy procedure, I walked off the table, and except for not drinking the chardonnay, ate dinner with my family. The anesthesiologist, Dr. Paul Rodrick was excellent as well.

Anonymous Patient

I was in a car accident and my lawyer set me up with Dr. Rappard. He is a real straight shooter who wants the best for his patients. He took care of me and totally fixed my back problem. I would highly recommend him.

Anonymous Patient

Dr. George Rappard was very professional and I felt he sincerely cared about my well being. I was injured in a slip and fall and my treatment lasted almost 3 years. I never felt rushed while in his office and received a high level of care. Dr. Rappard kept me appraised of my progress and my experience with his treatment was positive. He did an excellent job with my spinal cord stimulator implant and discectomy. I was very nervous but Dr. Rappard was reassuring. It takes a lot to allow someone to work in your spine, and it is scary, but I trusted Dr. Rappard and he didn't let me down. His office staff are caring, friendly, and terrific! I highly recommend him.

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NeuroEndospine Surgery Procedures

Endoscopic Anterior Cervical Discectomy

Endoscopic anterior cervical discectomy is a form of spine surgery used to treat patients suffering from neck pain or spinal nerve pain (cervical radiculopathy) due to a cervical disc herniation.  The procedure is performed through a band-aid incision.   The herniated disc is removed with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure avoids injury to normal portions of the disc and maintains normal spinal strength and stability.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Posterior Cervical Discectomy

Endoscopic posterior discectomy is a minimally invasive procedure used to treat patients with neck pain and spinal nerve pain (cervical radiculopathy) due to some forms of cervical disc herniation.  The procedure can also be used to treat cervical radiculopathy caused by a form of spinal degeneration called stenosis.  Endoscopic posterior discectomy is performed through a band-aid incision.   The herniated disc is removed with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure avoids injury to normal portions of the disc and maintains normal spinal strength and stability.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Cervical Facet Debridement

Endoscopic cervical facet debridement is a minimally invasive procedure that is used for patients with neck pain and headaches coming from the cervical facet joints.  The cervical facet joint is a paired joint on either side of the disc.  Cervical facet pain can be seen with degeneration or whiplash injury.  Endoscopic cervical facet debridement is performed through a band-aid incision.   The painful facet joint is treated with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  Treatment consists of releasing the painful joint capsule and injured tissue within the joint.  The surgeon will also coagulate the nerve endings within the painful joint capsule, relieving pain sensation.  Unlike other treatments for cervical facet pain, this minimally invasive hi-tech procedure can provide a cure without resulting to spinal fusion.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

Endoscopic Thoracic Transforaminal Discectomy

Endoscopic thoracic discectomy is a minimally invasive procedure that is used for the treatment of upper back pain and nerve pain (radiculopathy) due to disc herniations of the thoracic spine. The procedure is performed through a band-aid incision. The herniated disc is removed with micro-instruments using an endoscope, high-resolution HD video and a heads-up surgical display. This minimally invasive hi-tech procedure avoids injury to normal portions of the disc and maintains normal spinal strength and stability. Endoscopic thoracic discectomy is one of the few ways to treat a thoracic disc herniation without performing open chest surgery. This is an out-patient procedure where patients return home the same day. A rapid recovery is expected and patients start to resume activity the next day.

Endoscopic Thoracic Laminotomy

Endoscopic thoracic laminotomy is a minimally invasive procedure used to treat patients suffering from nerve and spinal cord compression due to spinal stenosis.  This compression results in conditions known as thoracic radiculopathy and myelopathy.  This procedure is performed through a band-aid incision.  Micro-instruments, an endoscope, high-resolution HD video and a heads-up surgical display are used to remove overgrown and degenerated bone and ligaments that are compressing neurological structures.  Injury to normal structures is minimalized and patients return home the same day.  A rapid recovery is expected and patients can begin light activity the next day.

 

Endoscopic Thoracic Facet Debridement

Endoscopic thoracic facet debridement is a minimally invasive endoscopic procedure used to treat patients with upper back pain originating from the thoracic facet joints.  The procedure is performed through a band-aid incision.  Micro-instruments, an endoscope, high resolution HD video and a heads-up surgical display are used to visualize the injured thoracic facet joint.  The facet joint capsule is incised, relieving strain.  The facet joint is then inspected for torn or injured joint components that may be causing pain with motion of the upper back.  This minimally invasive procedure is performed with minimal disruption to normal muscles and ligaments of the thoracic spine.  As a result, patient's return home the same day.  A rapid recovery is expected and light activity can begin on the following day.

Endoscopic Transforaminal Lumbar Discectomy

Endoscopic transforaminal lumbar discectomy is a minimally invasive procedure that is used for the treatment of low back pain and nerve pain (sciatica or lumbar radiculopathy) due to a lumbar herniated disc.  The procedure is performed through a band-aid incision.   The herniated disc is removed with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure avoids injury to normal portions of the disc and maintains normal spinal strength and stability.  In many cases, endoscopic transforaminal lumbar discectomy may be performed instead of a lumbar fusion.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Interlaminar Lumbar Discectomy

Endoscopic interlaminar lumbar discectomy is a minimally invasive procedure that is used for the treatment of low back pain and nerve pain (sciatica or lumbar radiculopathy) due to a lumbar herniated disc.  The procedure is performed through a band-aid incision.   The herniated disc is removed with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure avoids injury to normal portions of the disc and maintains normal spinal strength and stability.  In many cases, endoscopic interlaminar lumbar discectomy may be performed instead of a lumbar fusion.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Lumbar Decompression

Endoscopic lumbar decompression is a minimally invasive procedure that is used for the treatment of lumbar spinal stenosis.  Spinal stenosis is a condition where the nerve passageways become narrowed due to degeneration of the spine.  The degeneration and narrowing results in compression of spinal nerves, resulting in pain and dysfunction.  The procedure is performed through a band-aid incision.   The nerve passageways are opened with micro-instruments using an endoscope, high resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure minimizes injury to normal portions of the spine and helps to maintain normal spinal strength and stability.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Lumbar Fusion

Endoscopic lumbar fusion is used for the treatment of low back pain due to degenerated disc or instability of the spine.  Instability of the spine is the abnormal and painful movement of one vertebra on another.  This is sometimes referred to as a “slippage” when one vertebra has slipped forward on another.  The medical term for “slippage” is spondylolisthesis. The endoscopic lumbar fusion procedure is performed through small incisions.  The goal of surgery is to treat disc pain, relieve nerve pressure and stabilize the spine by removing the disc and replacing it with bone.  The procedure is performed using an endoscope, micro-instruments, high-resolution HD video and a heads-up surgical display.  This minimally invasive hi-tech procedure minimizes injury to normal portions of the spine and helps to enhance normal spine strength and stability after the fusion procedure.  This is an outpatient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Lumbar Rhizotomy

Endoscopic lumbar extra-dural nerve avulsion (or rhizotomy) is a minimally invasive procedure that is used for the treatment of low back pain due to an injured or painful lumbar facet joint. The lumbar facet joint is a paired joint, just behind and on either side of the disc. The procedure is performed through a band-aid incision. Using an endoscope, high resolution HD video and a heads-up surgical display, the surgeon snips the pain sensing microscopic nerves of the facet joint. This renders the joint painless while maintaining the normal strength, stability and motion of the joint. This minimally invasive hi-tech procedure is the only non-fusion cure available for lumbar facet pain. This is an out-patient procedure where patients return home the same day. A rapid recovery is expected and patients start to resume activity the next day.

 

Endoscopic Sacroiliac Rhizotomy

Endoscopic sacroiliac extra-dural nerve avulsion (or rhizotomy) is a minimally invasive procedure that is used for the treatment of low back and buttocks pain due to an injured or painful sacroiliac joint. The sacroiliac joint is a paired joint, one on either side of the buttocks.  The joint joins the pelvis to the part of the spine known as the sacrum. The procedure is performed through a band-aid incision.   Using an endoscope, high resolution HD video and a heads-up surgical display, the surgeon snips the pain sensing microscopic nerves of the sacroiliac joint.  This renders the joint painless while maintaining the normal strength, stability and motion of the joint.  This minimally invasive hi-tech procedure is the only non-fusion cure available for sacroiliac joint pain.  This is an out-patient procedure where patients return home the same day.  A rapid recovery is expected and patients start to resume activity the next day.

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