Endoscopic Microdiscectomy and Laminectomy

Endoscopic spine surgery is a minimally invasive approach that uses two small portals (one for a camera and one for instruments) compared to the larger incision required in traditional open surgery. Dr. Kazarian views the surgical area through a high-definition endoscopic camera rather than opening the back with a wide incision. Because the muscles are gently dilated apart rather than cut, patients generally experience less pain, less blood loss, less scarring, and a significantly faster recovery. The two-portal technique also provides better visualization and instrument maneuverability compared to single-portal approaches. Open surgery may still be recommended in certain complex cases, and Dr. Kazarian will discuss the best approach for your specific condition.

Endoscopic spine surgery typically takes between 45 and 90 minutes, depending on the complexity of your condition and whether additional decompression such as a laminectomy is needed. You should plan to be at the hospital for approximately four to six hours total, which includes check-in, pre-operative preparation, the procedure itself, and time in the recovery room before you are discharged.

Yes, the majority of patients who undergo endoscopic spine surgery are able to go home the same day. Because the procedure is minimally invasive, most patients are walking within one to two hours after surgery and can be safely discharged once they are comfortable, able to walk, and their pain is well controlled. In rare cases, an overnight stay may be recommended for monitoring. You will need a responsible adult to drive you home and stay with you for the first 24 hours.

Most patients report that postoperative pain from the incision site is mild to moderate and very manageable. Dr. Kazarian will send you home with the following medications as needed: • Tylenol (acetaminophen) 500–1000 mg every 6 hours for mild pain • Flexeril (cyclobenzaprine) 5 mg every 6 hours for muscle spasms or soreness • Tramadol 75 mg every 6 hours for moderate to severe pain not controlled by Tylenol alone Many patients are pleasantly surprised by how little pain they experience and are able to transition to just over-the-counter Tylenol or ibuprofen within the first week. Importantly, the leg pain or sciatica that brought you to surgery often improves immediately or within the first few days. Some residual numbness or tingling in the leg may take several weeks to fully resolve as the nerve heals.

Recovery from endoscopic spine surgery is considerably faster than from traditional open spine surgery. Most patients are able to care for themselves immediately after surgery, including everyday activities such as cooking, cleaning, bathing, and walking. However, unrestricted activity (including heavy lifting, exercise, and sports) requires approximately six weeks to allow the wound to fully heal and minimize the risk of a reherniation. For return to work, patients with office or work-from-home jobs can typically go back as soon as they feel comfortable, usually around one week after surgery. Patients with more physically demanding or manual labor jobs should plan on approximately six weeks before returning to full duties.

Endoscopic spine surgery is considered a safe and well-established procedure, but like all surgeries, it carries some risks. Potential complications include infection, bleeding, nerve injury, spinal fluid leak (dural tear), and recurrence of the disc herniation. The minimally invasive technique is associated with lower overall complication rates compared to traditional open surgery. Serious complications are rare. Dr. Kazarian will discuss the specific risks and benefits as they apply to your individual case during your pre-operative consultation.

Endoscopic spine surgery has a high success rate for relieving sciatica caused by a herniated disc pressing on a spinal nerve. Studies show that approximately 85 to 95 percent of patients experience significant or complete relief of their leg pain after the procedure. Many patients notice an improvement in their leg symptoms immediately after surgery. However, numbness, tingling, or mild weakness that was present before surgery may take longer to resolve, sometimes several weeks to months, as the nerve gradually heals. Dr. Kazarian will discuss realistic expectations based on your specific condition.

While some patients may benefit from physical therapy after endoscopic spine surgery, most do not feel the need for it due to the minimally invasive nature of the procedure and the quick recovery. The decision about whether physical therapy is appropriate for you will be made at your six-week follow-up appointment, when Dr. Kazarian can assess your progress and determine if additional rehabilitation would be helpful. If recommended, physical therapy typically focuses on core muscle strengthening, improving flexibility, and teaching proper body mechanics to protect your spine during daily activities.

Most patients are cleared to drive within one to two weeks after surgery, provided they are no longer taking prescription opioid pain medications and can comfortably perform the motions required for safe driving, such as turning to check mirrors and pressing the brake pedal quickly. Dr. Kazarian will evaluate your readiness at your first follow-up appointment. Driving while taking narcotic pain medication is unsafe and not permitted. If you had surgery on your right side and drive an automatic transmission, you may need to wait until you can press the brake pedal firmly and without hesitation.

Your return-to-work timeline depends on the physical demands of your job. Patients with office or work-from-home jobs can typically return as soon as they feel comfortable, usually around one week after surgery. Patients with more physically demanding or manual labor jobs should plan on approximately six weeks before returning to full duties. This six-week timeline allows the surgical wound to fully heal and minimizes the risk of a reherniation. Dr. Kazarian will confirm your readiness to return at your follow-up appointments.

Yes, in many cases bone may be removed during endoscopic spine surgery. During the surgery, Dr. Kazarian may perform a laminectomy where a small portion of the lamina bone is precisely removed to widen the spinal canal if needed to relieve pressure on the spinal nerves. This is often combined with disc removal in a single procedure to achieve the best outcome for the patient. The amount of bone removed is minimal and precisely targeted to decompress the nerve while preserving the surrounding healthy structures.

No, the entire disc is not removed during endoscopic spine surgery. Dr. Kazarian only removes the portion of the disc that is pressing on the nerve - specifically the herniated or bulging fragment that is causing your symptoms. The goal is to relieve pressure on the spinal nerve while preserving as much of the healthy disc tissue as possible. This selective removal helps maintain the disc's function as a cushion between your vertebrae while eliminating the source of your pain. This targeted approach is one of the advantages of the minimally invasive technique - it allows Dr. Kazarian to precisely remove only the problematic tissue while protecting the surrounding healthy structures.

Dr. Kazarian completed his undergraduate education at Princeton University and earned his medical degree from the University of Michigan Medical School. He completed his orthopaedic surgery residency at Harvard Medical School and Massachusetts General Hospital, followed by a fellowship in spine surgery at the Mayo Clinic.