The transiliac endoscopic discectomy is a novel spine procedure that was introduced by the Orthopedic and Wellness team at the International Society for Minimal Intervention in Spinal Surgery in 2013. A collaborative study performed in part by Orthopedic and Wellness physicians showed that the transiliac endoscopic approach had great success when performed on patients with high iliac crests. The L5-S1 area refers to the very base of the spine near the buttocks. This can be a tricky area to access in surgery, so the Orthopedic and Wellness team uses this new approach to reach the top of the pelvis on the patient’s back side. The procedure is performed using an endoscope or a thin instrument with a light and camera attached. The surgical site appears on a screen in the operating room so the physician can make small incisions without difficulty. This procedure is typically performed on patients with damaged spinal discs because it removes parts of the disc or bone fragment that may be putting pressure on the nerve and causing pain.
Once patients arrive at the surgery center, they may be asked to change into a surgical dressing gown. Patients are welcome to ask any last-minute questions at this time. When the patient is ready, an anesthesiologist administers light sedation and a local anesthetic near the incision site. Patients will be positioned face down (prone) during the procedure. Once the area is sterilized to reduce the risk of infection, the surgeon can begin. The surgeon will use a device called a fluoroscope to pinpoint exactly where the surgical instruments will be used inside the body. After an opening through the trans-iliac region is created, the physician will make repairs as needed. This approach allows the physician to do a number of repairs, including spinal decompressions, fusion, and more.
Overall, the procedure should take about an hour to complete. Patients are briefly monitored and given post-operative instructions before returning home the same day. According to the study conducted in part by the Orthopedic and Wellness team, most patients report a dramatic decrease in their back and leg pain following the procedure. However, patients should still spend at least a week recovering at home. During this time, patients should avoid strenuous activity and follow post-operative instructions very closely. Patients should not submerge their surgical dressings in a bath, and they should only touch them with clean hands to avoid infection. If any concerns arise, like a fever, a sudden increase in pain, or signs of infection, patients should call Orthopedic and Wellness immediately. Complications are rare, and as the study showed, complications from the surgery usually went away after the first two weeks. After recovering, patients may resume regular activities.