Dr. Giovanini 850.934.7545   |   Dr. Metzger 850.466.2703

Patient Resources

New Patients

Endoscopic Spine Program

Endoscopic Spine Program
Endoscopic Spine Program

NMS is pleased to now offer Endoscopic Spine solutions for various conditions of the spine. Using state of the art arthroscopic platform we can now do pain ablative procedures for low back and neck pain. Endoscopic Rhizotomy takes traditional rhizotomy techniques to the next level by allowing visualization of the nerves going to the painful facet joint. Endoscopic discectomy, foraminotomy and laminotomy can also be done safely and effectively in certain cases as an outpatient procedure accomplished through a tiny incision. Combining Robotics and Endoscopy for lumbar fusions can also be done to avoid traditional open fusions in certain cases. Our outpatient facility has a Mazor Robot and Endoscopic equipment to facilitate these ultra-minimally invasive procedures.

At NMS we have trained Neuro/Orthopedic Surgeons and ultra-specialized fellowship trained Interventional Pain physicians to evaluate and treat spinal conditions with endoscopic techniques.

Endo-Rhizotomy
Endo-Rhizotomy

Patients with axial neck and back pain can benefit from this procedure by transiently transecting the nerves going to the painful facet joints. With this technique the endoscope is passed easily through a tiny incision and docked on the facet joint. Under visualization the nerves going to the facet joints are then cauterized and transected. A small arthroscopic shaver can be utilized to remove bone spurs or calcified ligaments that may be entrapping nerves and causing pain. This technique is superior to traditional needle procedures in that more of the nerves can be lysed and hence provide better long -term pain control. This is done as an outpatient procedure and can be done in centers with appropriate endoscopic equipment. If required, an endo-rhizotomy can be combined with regenerative medicine techniques to decrease scar tissue and promote regrowth of cartilage in the facet joints.

Endo-Decompression
Endo-Decompression

Minimally invasive approaches to the spine can be accomplished with Endoscopic techniques. Simple decompressive laminotomies can be performed to easily remove bone and ligament through the endoscope. This is done as an outpatient with minimal recovery time. Endo-decompression can be performed for moderate lumbar stenosis with sciatic (leg) pain. If there is a herniated disc causing nerve impingement and sciatica, this can also be easily removed in most cases with endoscopic techniques. This is also an outpatient procedure with minimal recovery time. Lastly, patients who have been offered a lumbar fusion should consider endoscopic foraminotomy as an initial procedure in an attempt to avoid lumbar fusion. Foraminal stenosis is where the exiting nerve is pinched and can be relieved by endoscopic decompression.

Robo-Endoscopic Fusion
Robo-Endoscopic Fusion

If lumbar fusion is recommended then it can be done using robotics for precisely targeting a safe entry point into the disc space and endoscopic techniques for decompression and removing disc material. Endoscopic placement of the interbody cage or device is also possible. This can all be done safely through two tiny incisions in the back on an outpatient basis. The robot is used for targeting and positioning of devices in a safe accurate precise manner.

Endo-SI-Ablation
Endo-SI-Ablation

Sacroiliac pain is a very common cause of low back pain. If the diagnosis is made then ablation of the nerves traveling to the SI joint can be done either traditionally with needles and heat or more completely with endoscopic rhizotomy. Mechanical and thermal lesioning of the pain producing nerves is superior to thermal alone with traditional radiofrequency ablation (RFA).

Please note endoscopic procedures are not for every patient. At NMS we have providers that are experts in guiding patients towards the right procedure. We offer traditional appointments and telemedicine visits for interested patients.