ATLANTA - Emory University Hospital Midtown is the first and only academic medical center in Georgia to offer endoscopic spine procedures using new technology to decrease recovery time and pain for patients undergoing spine surgery. As part of its mission to improve lives and elevate health care, Emory Healthcare is pioneering the use of these advanced procedures that are minimally invasive where doctors use a small camera and tools through tiny incisions to perform surgery.
With the new technology, Emory neurosurgeons and spine surgeons can perform a variety of ultra-minimally invasive (UMI) endoscopic spine surgeries, including treating herniated discs.
“The smaller the surgery, the faster patients can recover and get back to a normal life,” says Matthew Gary, MD, associate professor of neurosurgery, Emory University School of Medicine. “We want to do everything we can to minimize pain and maximize recovery, and in general, we’ve found the outcomes are better with this ultra-minimally invasive procedure.”
Carl Moore, a welder, returned to work within a week of his ultra-minimally invasive endoscopic spine surgery.
Photo provided by Emory Healthcare
A herniated disc occurs when the exteriors of rubbery cushions, known as discs, weaken and those cushions push out between the bones that make up the spine. These protrusions can then press against nerves and cause pain in the lower back, legs and thighs. Experts estimate up to 10 percent of patients with disc herniations could benefit from surgery to remove pressure on the nerves.
During these UMI spine surgeries for herniated discs, surgeons create an incision as small as the tip of a number two pencil to repair the discs and relieve pain in patients. The new method allows patients to walk out of a hospital the same day as the surgery.
Gary and his colleagues Daniel Refai, MD, professor of neurosurgery and orthopaedics and director of spinal oncology at Emory Spine Center and Juanmarco Gutierrez, MD, assistant professor of neurosurgery at Emory, specialize in complex spine surgeries including endoscopy at Emory University Hospital Midtown.
As of early December 2024, Gary, Refai and Gutierrez had completed more than 160 endoscopic surgeries using the new technology. They are also able to perform various complex surgeries, such as thoracic disc resections, cervical foraminotomies (to relieve pressure and pain from a pinched nerve in the neck) and lumbar laminectomies (to relieve lower back pain by alleviating nerve compression) with the endoscopic approach - allowing them to reach difficult areas in the spine.
“Endoscopic spine surgery has been around for decades,” says Refai. “But now, the visualization is incredible! We’re not using microscopes anymore because it’s an endoscope, which is a light source with a 4K camera. I’m able to look around the nerve roots and underneath the nerve - things I couldn’t do before and we’re doing it with very little manipulation of tissue.”
Depending on the severity of the case, endoscopic spine surgeries can take 45 minutes to an hour using this new technology, compared to at least an hour-and-a-half and an overnight hospital stay with a traditional open surgery. Thanks to the new ultra- minimally invasive technology and procedure, patients typically only need muscle relaxants or over-the-counter pain relievers for recovery instead of opioids.
“I generally tell patients to take a good two weeks off after the procedure, but many of them within the first two or three days are back to a normal lifestyle,” says Gary.
“This technology represents a significant advancement in patient care, offering quicker recovery times and less postoperative pain,” says Daniel Barrow, MD, the Pamela R. Rollins Chairman and Professor of Neurosurgery at Emory. “Emory is proud to be the first in Georgia offering this cutting-edge treatment to our patients.”
Emory University Hospital Midtown is expected to acquire new endoscopic technology in 2025 to be able to offer this unique approach for treating herniated discs to more patients.