In Hungary, Semmelweis University’s Department of Neurosurgery and Neurointervention was the first to use the single-channel (uniportal) lateral transforaminal endoscopic spinal surgery technique, which involves bony decompression (nerve release) and is suitable for the treatment of certain spinal disc herniations. Its introduction, practical application, and educational support was led by Dr. Loránd Erőss, Director of the Department of Neurosurgery and Neurointervention. The first intervention was performed with the participation of Clinical Lead Dr. Péter Banczerowski, Head of the Department of Neurosurgery; clinician Dr. György Berényi; and resident Dr. Zoltán Nagy. The surgery is performed with a special device that includes a high-resolution camera and channels for the use of instruments specially developed for this purpose, which allow for precision intervention.
The procedure can be performed under local or general anesthesia. The single-channel endoscopic technique requires only a 1-cm incision through which the instrument is inserted, which also serves as a working channel for the camera and surgical instruments. This procedure can significantly reduce damage to muscles and soft tissue. This is particularly important for the preservation of muscle structures around the spine, which contributes to faster recovery and long-term spinal stability. The endoscope gives the surgeon a real-time magnified view of the surgical site. Depending on the specific pathology, it can be used to remove spinal disc herniation, resolve nerve root canal stenosis, or release nerves.
After the instruments are removed, the small incision can be closed with a stitch or covered with a wound closure strip. The less significant tissue damage caused by the endoscopic technique means less pain after surgery and minimal scarring afterwards. Because of the smaller intervention and minimal tissue damage, patients recover more quickly and can usually be discharged home on the day of surgery or the day after. Single-channel endoscopic techniques also have a lower risk of infection, bleeding, and other surgical complications.
Uniportal endoscopic spinal surgery is a precision, targeted procedure for the treatment of certain selected spinal conditions. It can be used to treat spinal disc herniation, nerve root canal stenosis, and spinal stenosis when conservative treatment methods have been unsuccessful. Spinal disc herniation is one of the most common musculoskeletal disorders in Hungary, affecting 5-10 percent of the population in the 30-50 age group. Spinal stenosis is common in the over-50 age group, affecting around 4-8 percent of the population. Uniportal endoscopic procedures can be used in around 30 percent of spinal surgery interventions.
Eszter Keresztes (source: Department of Neurosurgery and Neurointervention)
Translation: Dr. Balázs Csizmadia
Image credit: Department of Neurosurgery and Neurointervention
