Edison, NJ, November 2010 - For millions of Americans, back pain is a simple, if unpleasant, fact of life. Research shows that roughly 80 percent of us experience it at some point in our lives. Happily, in 9 cases out of 10, that pain goes away. But for roughly 5 percent of those aching backs, the pain will be chronic. Americans spend at least $50 billion each year on medicines, hot and cold packs, and other methods of treating back pain, and back pain is second only to headaches as the most common neurological ailment in the United States.
Until now, patients had only one option, surgery, when other methods of pain control had failed, says Kaixuan Liu MD, PhD, a nationally renowned leader in endoscopic spine surgery and chief surgeon at Atlantic Spinal Care in Edison, N.J. Traditional (or "open") spinal surgery typically involves general anesthesia, a hospital stay, big scars and long recovery times. And unfortunately, in many cases, the surgery fails to provide lasting relief, leaving the patient to rely on narcotic pain relievers for the rest of his or her life.
Smaller Is Better
Happily, patients with chronic back pain have another option today, says Dr. Liu. "Now we can perform minimally invasive surgery using an endoscope, a tiny tube with a video camera on the end, which lets doctors see the spine and surrounding tissue without making a big incision," he says. Endoscopic spine procedures can be used to correct many of the conditions that cause chronic back pain, and can even repair failed previous surgeries.
"Spine surgery is a very common procedure for treatment of lower back pain," says Dr. Liu. These operations typically use cages, bone graft, bars, and screws. "If a patient continues to have pain, it is called failed back surgery syndrome, or FBSS," he says. "Unfortunately, the pain is often much worse than it was before the surgery, and many FBSS patients are disabled, isolated, and heavily medicated." FBSS occurs in 20 to 40 percent of open spine surgeries, he says, and, ironically, is often caused by scarring that was created by the surgery itself.
In an endoscopic spine procedure, muscles surrounding the spine are gently eased apart, not cut as they would be in an open surgery. "This means that we can make a tiny incision-less than the diameter of an adult small finger-and leave the surrounding tissue unharmed," says Dr. Liu. That speedy (and simple) procedure means less pain, risk of infection or other complications, and a much shorter recovery time for the patient, as well. In fact, most people leave the hospital the same day, and are back to their regular activities in about six weeks.
"Any change in the bones, nerves and other tissues of the spine can cause chronic pain," he says. The most common are disc degeneration, herniation (in which the jelly-like nucleus of a disk bulges out past the outer part of the disc), bone spurs (bony overgrowths that commonly occur in the back of the spine), pinched nerves, and spinal stenosis (a narrowing of the spinal canal most often caused by degeneration).
Dr. Liu uses endoscopic spine techniques to perform foraminotomies, which remove bone spurs, scars, protruding discs, and other problems, as well as lumbar discectomies, which repair disc bulges and hernias.
Research shows that endoscopic lumbar discectomies produce outcomes similar to standard discectomy surgeries-many patients are pain-free after two years-while providing several important advantages, such as faster recovery and less postoperative pain.
One drawback of endoscopic spine surgery, says Dr. Liu, might be in finding a qualified surgeon. "While more and more surgeons are offering this procedure, unfortunately, the learning curve for endoscopic spine surgery is very steep," says Dr. Liu, who has performed more than 800 endoscopic spine surgeries and is a member of the International Society for Advancement of Spine Surgery, The American Society of Interventional Pain Physicians (ASIPP), The American Academy of Pain Medicine (AAPM), and The International Intradiscal Therapy Society (IITS). "This technique is still in its infancy, and most of today's residents in orthopedic spine surgery and neurosurgery graduated without having been exposed to it."About: Kaixuan Liu, M.D., Ph.D., Dr. Liu is a leader in endoscopic spinal surgery. He has substantial experience in this rapidly developing field, and he treats disc herniations, spinal stenosis, failed neck or back surgeries, spondylolisthesis, and many other diseases and conditions in the cervical, thoracic, and lumbar spine. His patients come from all over the United States. Dr. Liu is certified by American Board of Pain Medicine and American Board of Anesthesiology. After fellowship training in Minimally Invasive Spine Surgery at the Advanced Orthopedic of South Florida, Dr. Liu founded Atlantic Spinal Care, LLC, in Edison, New Jersey.