Endoscopic fusion is a form of spinal fusion performed through a working channel and a high-definition camera inserted through an incision of about 8 mm. Under continuous visualisation, the surgeon decompresses the affected nerves, prepares the disc space and places an interbody implant with fixation, while aiming to preserve the surrounding muscle, bone and ligaments.
Traditional open spine surgery involves larger incisions and extensive muscle dissection, while standard MIS still requires some tissue handling through an incision of around 20 mm. The endoscopic approach is designed to reduce tissue damage, blood loss and postoperative pain while supporting faster recovery.
The treatment is considered more suitable for degenerative lumbar conditions such as disc disease, spinal stenosis and selected low-grade instability. It can also be used for persistent nerve-root compression causing leg pain after adequate conservative care, as well as revision or re-do spine surgery where previous open surgery has left scar tissue that would be riskier to operate through again. Selected elderly patients may also be considered for the procedure when a long open fusion would represent a heavier surgical burden.
“Endoscopic procedures are also used for disc herniation and nerve compression. In certain cases, they may help avoid the need for extensive fusion by preserving the spine’s natural stability. However, the suitability is decided after clinical evaluation, imaging and assessment of overall health. The technique is not suitable for all patients. High-grade slips, some complex deformities and cases that require wide open reconstruction may still need conventional surgery,” said Dr Keerthivasan P, Senior Consultant Spine and Orthopaedic Surgeon, Kauvery Hospital Alwarpet Chennai.
In appropriately selected cases, the intended benefits include a smaller wound, less muscle injury, lower blood loss, less postoperative pain, earlier walking and a shorter hospital stay.
In a recent complex case, a 56-year-old woman who had previously undergone L4–L5 open spine surgery later developed problems at the L3–L4 and L4–L5 levels. The team used an endoscopic approach to avoid operating through scarred tissue. Blood loss was less than 50 ml. The patient walked within two hours and was discharged within two days.
In another case, an elderly patient with severe leg pain caused by a disc problem was treated endoscopically, avoiding a major open operation that would have required long-segment fusion. The patient recovered quickly and returned to normal activity sooner than expected.
Dr Balamurali, Head of Department – Spine and Neurosurgery, Kauvery Hospital, Alwarpet, Chennai, added, “This advancement strengthens our comprehensive spine care programme, where patient selection, precision planning and multidisciplinary coordination play a crucial role in outcomes. Endoscopic fusion is not just about smaller incisions, but about choosing the right approach for the right patient. With this technique, we are able to expand our treatment spectrum and offer personalized solutions, especially in complex and revision spine cases.”
Speaking on the technology, Dr Aravindan Selvaraj, Co-Founder and Executive Director Kauvery Hospitals, said, “Our focus is to combine clinical expertise with advanced technology to deliver effective treatment while reducing the overall burden of surgery. The introduction of endoscopic fusion surgery reflects our commitment to offering less invasive options wherever appropriate.”
The introduction of endoscopic fusion at Kauvery Hospital, Alwarpet, expands the hospital’s spine treatment spectrum for appropriately selected patients, including those requiring complex or revision procedures, while focusing on a less invasive surgical approach.
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