Updated September 2019
Fellows and residents in the Department of Anesthesiology now have the rare opportunity to learn and train on a new minimally invasive endoscopic spinal procedure to treat conditions such as herniated discs or spinal stenosis thanks to the work of an interventional pain physician in the Department of Anesthesiology.
Sanjeev Kumar, MD, Assistant Professor of Anesthesiology, has begun performing endoscopic spinal decompression at UF Health, after refining his skills with the help of a $9,310 Faculty Enhancement Opportunity (FEO) grant. The procedure uses a small endoscope, camera, continuous irrigation, and small instruments to remove/decompress a herniated disc or open up space for a nerve to relieve stenosis in the lumbar region of the spine.
Minimally invasive, endoscopic spine surgeries are as effective as traditional open spine surgeries for certain conditions and are performed on an outpatient basis. The patients are usually only mildly sedated during these procedures and have significantly less postoperative pain, accelerated recovery, and minimal tissue damage and scarring. If spinal injections have not adequately treated a problem, an endoscopic procedure could prevent a patient from undergoing a major conventional spine surgery, Dr. Kumar said.
Other traditional spinal surgical procedures such as laminectomy involve cutting open the spine, which creates more instability and scarring. By contrast, endoscopic spinal decompression does not interfere with the spine’s stability and does not exclude the patient from having a more traditional spinal surgery in the future if needed, he said.
While there are some spine surgeons and neurosurgeons who perform these procedures at other select institutions, Pain Medicine Fellows and Anesthesiology Residents at UF are likely among very few in the country to have the opportunity to gain exposure and training in this kind of surgery, Dr. Kumar said.
“It’s where the future is,” he said. “It offers a unique experience for our fellows and residents.”
He became intrigued by the procedure through his connections to the medical community in India, where he gained hands-on experience in it last year.
Dr. Kumar used part of the FEO grant to travel to a Lumbar Endoscopic Spinal Decompression Review Course and cadaver workshop hosted by the American Society of Interventional Pain Physicians in July in Memphis, Tennessee.
Earlier this year, he also attended a workshop in New York to receive formal training in endoscopic spine surgery.
He has now been performing the surgeries at UF Health since mid-August and said that through mid-September, the process has been very successful, with all patients who have been operated on reporting very positive outcomes.
As a pain physician, Dr. Kumar said he views minimally invasive surgical techniques as advancing his ability to effectively manage patients’ acute and chronic, painful spinal conditions.
Daniel Hoh, MD, of the UF Comprehensive Spine Center, an Associate Professor of Neurosurgery, said endoscopic nerve decompression has been shown to relieve a certain subset of spinal pain with similar success as surgery, but with a less invasive approach.
For now, the procedure is being performed primarily at the Florida Surgical Center because the facility has towers for the endoscopic equipment. Depending on demand, clinicians could start performing the procedure at other UF Health locations, Dr. Kumar said.
The procedure is expected to complement services offered at the spine center, which opened last year.
“Our goal is to offer a one-stop multidisciplinary destination for premier spine care, whether that involves surgery, interventional procedures, or therapy,” Dr. Hoh said.