Fellows and residents in the Department of Anesthesiology are poised to have the 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, is implementing endoscopic spinal decompression at UF Health, and plans to refine his skills with the help of a $9,310 Faculty Enhancement Opportunity (FEO). The procedure uses cameras and small instruments to decompress a herniated disc or open up space for a nerve to relieve stenosis in the lumbar region of the spine.
Minimally invasive techniques typically reduce postoperative pain, shorten a patient’s hospital stay, accelerate recovery, and minimize 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 spinal surgery, Dr. Kumar said.
Other spinal procedures such as laminectomy involve cutting open the spine, which creates more instability. By contrast, endoscopic spinal decompression does not interfere with the spine’s stability and can be conducted on an outpatient basis and under sedation rather than general anesthesia, he said.
While there are a few neurosurgeons in private practice who perform the procedure, UF’s Pain Medicine Fellowship is expected to be one of very few in the Southeast that teaches it, Dr. Kumar said.
“It’s where the future is,” he said. “It can offer 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. Earlier this year, he attended a cadaver workshop in New York to receive training from Elliquence, one of the two companies that manufacture the equipment used in endoscopic spinal surgery.
Based on his training and experience, Dr. Kumar has received privileges from UF Health to perform the procedure. On June 13, he made a new product request to UF Health’s Value Analysis Committee for endoscopic spine surgery on Elliquence equipment; the committee’s decision is pending.
Dr. Kumar plans to begin teaching fellows and residents the technique, and he plans to improve his own skills: He will use part of the FEO 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.
As a pain physician, Dr. Kumar said he is well positioned to perform the procedure because of his knowledge of fluoroscopy and discs; he views minimally invasive surgical techniques as advancing his ability to manage patients’ acute and chronic painful 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.
In the beginning, the procedure is expected to be performed primarily at the spine center because the facility has a tower for the endoscopic equipment. Depending on demand, clinicians could start performing the procedure at UF Health Pain Medicine’s Ayers location downtown, 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.
FEO funding is awarded for creative and flexible faculty development activities and is available to full-time faculty members. Awards are intended to contribute to the professional career goals of individual faculty members and to the goals of the university overall. Faculty members can receive an FEO award once every 6 years.