Most patients with a herniated or bulging disc do not need surgery. It is important for a spine surgeon to carefully examine you for any signs of weakness before making a final recommendation.
Despite the frequent advertising on TV and the Internet, there are no spinal procedures that can be performed with just a laser. Many of these “laser” procedures simply use a laser to burn tissue, but still use standard spinal retractors. Endoscopic spine surgery is different because it uses a scope. Endoscopic instruments allow the surgeon to see more structures in the spinal canal through a very small incision. The incisions performed with an endoscopic camera are also smaller – 7mm in some cases.
Endoscopic spine surgery uses a endoscope that is placed into the spine. To confirm the level and to assist with targeting, a spine surgeon will use fluoroscopy. For an experienced endoscopic spine surgeon, there is hardly any radiation exposure with the surgery. For surgeons with less experience with endoscopy, often a CT scan or sometimes a robot might be used for targeting. Ultimately, the goal is to perform the procedure safely, so each surgeon should use the tools necessary to ensure competency. Yet with a CT scan or robot there is often extra radiation exposure to the patient and sometimes extra incisions. Extra incisions will often defeat the purpose of doing a minimally invasive endoscopic discectomy. As an experienced national instructor for endoscopics, Dr. Zahir has trained dozens of surgeons nationally on the most effective methods of performing the procedure safely.
Typically a patient can go home shortly after surgery. Most patients feel less pain than traditional surgery.
Each surgeon will recommend a treatment that they are most comfortable performing. Most patients will still get good results with traditional surgery. However, for patients who are interested in undergoing endoscopic spine surgery, there are many conditions that can be treated safely: lumbar disc herniations, lumbar stenosis, lumbar foraminal stenosis, and even some cases of lumbar spondylolisthesis. We frequently see patients seeking second opinions. If your surgeon has turned you down from an endoscopic procedure and is recommending a spinal fusion, there is no harm getting a second opinion.
Not every patient is a candidate for endoscopic spine surgery. A surgeon needs to carefully review the patient’s history, physical exam, and imaging studies to determine whether it would be possible. Patients should bring all prior records to their appointment.
A significant portion of Dr. Zahir’s practice involves providing second opinions to patients who are already planning to have surgery. Since our practice is one of the few facilities nationwide dedicated to endoscopic spine surgery, we are happy to provide second opinions and help review your case. We take pride in patient education, and will ensure that by the end of the appointment you have a solid understanding of your condition even if you decide to have surgery performed elsewhere.
This procedure is covered by medicare, medicaid and some private insurances. Always check with your insurance company or inquire through our offices on whether this is covered by your insurance.
We currently have three office locations. The two main offices are in Virginia, and are division of The Orthopedic Group, a practice based out of Leesburg/Lansdowne, Virginia. We also have a Maryland location, which is a satellite office. The Maryland location is a collaboration between Dr. Zahir and Metro Orthopedics & Sports Therapy, a practice based in Potomac, MD. The office services provided in Virginia and Maryland are completely separate. So if you see Dr. Zahir in Maryland, we would request to continue care at that location. If you see Dr. Zahir in the Virginia offices, we would similarly request that you continue care at that location as well. This will keep the care streamlined. Surgeries can be performed in either state, although the majority of the procedures are performed in Virginia.
For patients in the Northern Virginia/DC region, surgeries are performed at StoneSprings Hospital Center. For patients in Central Virginia, the procedures are performed at Spotsylvania Regional Medical Center. For Maryland, Dr. Zahir has several options available for his patients. We also offer the flexibility in scheduling post-operative appointments through telemedicine for patients that travel from out of state.