Endoscopic Spine Surgery

What is endoscopic spine surgery?

Endoscopic spine surgery is a minimally invasive technique that uses a thin tube fitted with a camera and light — an endoscope — passed through a small opening about the width of a pencil. Working through that tube under live X-ray and high-definition video, Dr. Eaddy treats the source of pain with very little disruption to surrounding muscle and tissue, often under light sedation and as an outpatient.

What conditions does it treat?

Two of the most common uses are endoscopic discectomy — removing the portion of a herniated disc that is pinching a nerve and causing sciatica or arm pain — and endoscopic facet joint denervation, which interrupts the small nerves that carry pain from arthritic facet joints in the spine. It is considered when targeted, less invasive care such as epidural steroid injections has not given lasting relief.

How is endoscopic discectomy performed?

Through a small incision, the endoscope is guided to the herniated disc under X-ray. Dr. Eaddy removes only the fragment compressing the nerve, relieving the pressure that causes radiating leg or arm pain while preserving the rest of the disc and the surrounding muscle. Randomized evidence shows full-endoscopic discectomy relieves leg pain at least as well as traditional open microdiscectomy, with less blood loss and a faster recovery.

What is endoscopic facet joint denervation?

The facet joints are small joints at the back of the spine that can become a source of chronic neck or back pain. Endoscopic facet denervation uses the endoscope to directly visualize and interrupt the medial branch nerves that carry pain from an arthritic facet joint — an endoscopic counterpart to radiofrequency ablation that can offer durable relief for carefully selected patients.

What is recovery like?

Because the incision and tissue disruption are minimal, most patients go home the same day and return to light activity within days. Heavy lifting, bending, and twisting are limited for a few weeks. Recovery is generally quicker than after open spine surgery, though your exact timeline depends on the procedure and your condition.

What are the risks?

Endoscopic spine surgery is minimally invasive, but as with any spine procedure there are risks, including:

• Infection
• Bleeding
• Nerve injury
• Dural puncture (spinal-fluid leak) causing a temporary headache
• Incomplete relief or recurrence of the disc herniation that may require further treatment
• Conversion to an open procedure in rare cases

Reducing the risk of infection before your procedure

To lower the already-small risk of infection, Dr. Eaddy uses a skin-preparation protocol in the days before your procedure. Follow the exact instructions the office gives you — in general it involves:

• Mupirocin antibiotic ointment — applied twice daily for the five days leading up to your procedure.
• Hibiclens (chlorhexidine gluconate) antiseptic wash — used each day for the four days before your procedure, and once more on the morning of the procedure.

This reflects published evidence that decolonizing the skin and nose with mupirocin and chlorhexidine (Hibiclens) lowers the rate of surgical-site infection. See preparing for an interventional pain procedure for the rest of your pre-procedure checklist.

Trusted resources

Learn more from these independent medical sources:

• MedlinePlus (National Library of Medicine) — Herniated disk
• American Association of Neurological Surgeons — Minimally Invasive Spine Surgery
• Gadjradj et al. — Full endoscopic versus open discectomy for sciatica: randomised controlled trial (BMJ, 2022)
• Li et al. — Endoscopic versus non-endoscopic discectomy: systematic review and meta-analysis (2021)

Related care

Conditions and treatments connected to this page, all provided by Dr. Eaddy:

• Sciatica — radiating leg pain from a compressed nerve root
• Back Pain and Neck Pain — diagnosis and treatment for spinal pain
• Radiofrequency Ablation — image-guided denervation for facet and sacroiliac joint pain
• Failed Back Surgery Syndrome — options when pain persists after spine surgery
• Patient guide: preparing for an interventional pain procedure — blood thinners, drivers, skin prep, and more

Reviewed by Kenneth J. Eaddy, MD · Updated July 2026