Endoscopic spine surgery reduces opioid use and postoperative pain

An emerging type of minimally invasive spine surgery reduces the use of pain medication in patients' recovery compared to those who undergo other less minimally invasive spine surgery, which use larger incisions that result in more postoperative pain, according to a study published in World Neurosurgery in September.

This retrospective study in 102 patients found that endoscopic spine surgery reduced the use of opioids by 21 percent right after surgery compared to other kinds of lower back surgery that were less minimally invasive. Moreover, the use of non-opioid pain medication was also reduced by 24 percent. This surgery, called unilateral biportal endoscopic discectomy, is an endoscopic technique that requires only two small incisions for a camera and surgical tools to repair herniated discs in the lower back. It is therefore extremely minimally invasive.

This breakthrough technique is a game-changer because it gives patients a better recovery, with less pain and less need for narcotics and their related side effects. This is a highly specialized area, and we are leading in the number of cases performed because we've seen the benefit this brings to our patients and their recovery."

Charla R. Fischer, MD, co-director of the Endoscopic Spine Surgery Program at NYU Langone Orthopedics and lead author on the study

While endoscopic spine surgery has shown early potential, until this study there was a lack of understanding how it compares in the use of pain medication to other minimally invasive techniques. In the background of the opioid crisis, focused efforts to reduce opioid use after surgery continue, and these initial findings are promising in reducing patients' pain and need for narcotics. Future studies with larger sample sizes and prospective designs could further inform the long-term outcomes of endoscopic spine surgery compared to other minimally invasive spine surgical procedures.

The Endoscopic Spine Surgery Program, a part of NYU Langone's Spine Center, is one of only a few in the United States. The program leads the way in creating treatment guidelines that ensure the safe and responsible use of new endoscopic techniques for spine surgery while allowing surgeons to provide the highest quality of care and the best possible outcomes for NYU Langone patients.