Endoscopic surgery is the next evolution in spine surgery, with endoscopic fellowships being offered in major teaching institutions throughout the world. Two minimally invasive methods, TESSYS and iLESSYS, provide more gentle endoscopic-technique options for spine surgery than non-endoscopic methods. Read on to find out what they are and what conditions they treat.
What is TESSYS?
TESSYS, also known as Transforaminal Endoscopic Surgical System, is a surgical method where the surgeon approaches the structures of the spine that need to be addressed with a lateral, transforaminal, endoscopic technique. Are you slightly confused? Let’s dissect these words, so to speak, to understand this gentle approach.
- Lateral — From the sides. The surgeon approaches the spine through its side.
- Transforaminal — Literally “across the foramina.” The foramina are openings along the spinal canal where the nerves exit. These provide natural openings for the surgeon to enter the area that needs repair, thereby minimizing damage. It is amazing how much can be repaired through these natural openings!
- Endoscopic — A minimally invasive surgical approach where the surgeon inserts an HD endoscope (camera) through a small incision to access the surgical field and visualize the structures of the spine on a larger scale.
Basically, the surgeon makes a small incision to insert the HD endoscope and enters the spinal canal through its side using your body’s natural openings, the foramina. Minimal damage with optimal results!
When is TESSYS used?
TESSYS is usually preferred for conditions located at the front (ventral) and sides of the spine, as well those involving the foramina.
This approach provides a gentle surgical option for:
- Herniated discs — A condition where the soft center of the intervertebral discs (rubbery discs that provide cushioning between the bones of the spine) leaks out into the tougher, outer portion of the disc.
- Foraminal stenosis — A condition characterized by a narrowing of the openings (foramen) in your spine. When these openings narrow, the nerves passing through them can become compressed. This can lead to pain, numbness/tingling, and weakness of the areas served by those nerves. (TESSYS and iLESSYS may be used concomitantly for spinal stenosis.)
- Facet Cyst – A cystic growth from the facet joint which makes up part of the foramen.
What is iLLESSYS?
Also a gentle, minimally invasive endoscopic approach, iLESSYS differs from TESSYS in its entry point and trajectory. Interlaminar Endoscopic Surgical System, or iLESSYS, is used for conditions located at the dorsal (back) spine.
Interlaminar simply means “between the lamina.” The laminae are located on the posterior part of the vertebra and provide an excellent entry point for back surgery.
This technique uses a “keyhole” approach that preserves muscles and soft tissue and minimizes trauma to ligaments and bones.
When is iLESSYS used?
iLESSYS is a preferred approach when the pathologies requiring surgery are located at the back of the spine or when the pathology is best accessed with this method, like those involving the lower back.
Examples of conditions treated with iLESSYS include:
Both TESSYS and iLESSYS approaches require only a 7mm-long incision and are the least invasive forms of addressing a pathology of the spine. Which approach is used depends on the location of the problem, but there are rare times when both entry techniques (or two TESSYS approaches) are used.
We’re excited that endoscopic fusion techniques are currently being developed as well; this will be the way fusions are performed in the coming decades!
“I was fortunate enough to receive endoscopic spine training in my fellowship and I was shocked to find out that nobody in the greater Los Angeles area was doing it when I moved here for my practice,”
Dr. Armen Oganesian, Fellowship-trained Orthopedic Spine Surgeon
These minimally invasive and gentle techniques mean shorter recovery time and less pain, scarring, bleeding, and postoperative complications. They’re the wave of the future, but available now!
Currently, Dr. Oganesian’s clinic, Modern Orthopedic Spine Specialists, is the only clinic within a 60-mile radius that offers TESSYS and iLESSYS techniques, and this includes the greater LA area and all of Ventura county!
Dr. Armen Oganeisian is an award-winning spine surgeon with years of experience and success with both TESSYS and iLESSYS methods. Call to see if these options are right for you!
For an individual consultation, contact Dr. Armen Oganesian at The Modern Spine Specialists today! Please contact The Modern Spine Specialists at 805-370-0748, or email us at firstname.lastname@example.org.
You can also visit our office at:
250 Lombard Stree
Thousand Oaks, CA 91360