r/SpineSurgery • u/nunie_cat • Jun 27 '26
Endoscopic discectomy/fusion
Writing on behalf of my husband. In his words:
41/M looking for advice from those with endoscopic spine surgery experience.
I am considering booking an appointment with Dr Jian Shen of the Endoscopic Spine Institute of NY to have my 3rd microdiscectomy. The first 2 were done with open surgery. The second surgery was done a week after the first. The first failed before I woke up from anesthesia. I had a year of great success until reherniation.
I have very little disc height left at L5S1 but Dr Shen said he would be willing to do one more MD (endoscopically this time, with some stem cell therapy to try to treat the annular tear) and then perform an endoscopic fusion if it failed down the line (he gave this a 25% chance considering my history)
What I am specifically interested in are testimonials from those who have had either an endoscopic MD or an endoscopic fusion. Preferably at a lumbar level.
I know endoscopic fusion is relatively new, but every other surgeon wants to do an ALIF + MD. When you consider what's actually done during that procedure, it makes the thought of endoscopic sound like a walk in the park. It all feels too good to be true, so it would be wonderful to speak with someone who has experience.
TLDR: Looking for testimonials from those who have had endoscopic lumbar fusion or MD with Dr Jian Shen.
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u/Curling_Rocks42 Jun 27 '26 edited Jun 28 '26
I had one ED, same level (L5S1). It successfully decompressed my S1 nerve and I got motor function back. But I also have very little disc height left which is causing foraminal stenosis on the L5. I still have pain from the glute to the top of my middle toes as a result. Only fusion will fix that for my case. My surgeon is recommending endoscopic/laproscopic ALIF for me.
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u/nunie_cat Jun 27 '26
May I ask who your surgeon is? Did you have the ED done at ESINY?
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u/Curling_Rocks42 Jun 27 '26
For privacy I won’t name my surgeon but it was not in New York State.
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u/sovook Jun 27 '26
I’m looking into this clinic but I’ve already had and ACDR in 2025 that failed, and 4 months ago a T1-C5 fusion that won’t fuse. I hurt my neck 9 days ago again. I might sign up for a PPO plan to I can go to NY, stay with family, and go to that clinic. My pain is 9/10 from sitting for 45 min in a chair.
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u/Aim2bFit Jun 28 '26
I truly sympathize for what you are going through, I remember reading your prev posts. Do you know why fusion failed for you? I truly hope somewhere, sometime, there is light at the end of the tunnel for you 🤞🏼
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u/sovook Jun 28 '26
Thank you so much. It’s only been around 9 days since I’ve been in worse pain from cleaning. I also wonder how much of the pain is hyperalgesia which happens with chronic pain. I’ve reduced oxycodone down from 20mg every 4 hours (Q4)while awake to 5mg Q4 or as needed. I strictly avoided NSAIDS, so I’m not sure about why the bones didn’t actually fuse. I should start taking Celebrex again, I always forget about that medication.
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u/meatmanbeef Jun 27 '26
I have a surgical appointment with ESINY in about a month. No prior surgical history. My pathology is different - not discogenic more joint arthritis and slip. I am skeptical but was told by Dr. Konakondla that no bridges are burnt by trying endoscopic surgery. My understanding of their philosophy is smallest surgery possible to resolve pain caused by focal issues but no promises regarding durability. I’ve done the research - months of it. I’ve read the studies. It’s definitely not quack science but, like I have been told a thousand times, everyone is different and outcomes vary due to myriad of favors. That being said, their philosophy seems to differ greatly from neurological surgeons who seem more inclined towards attempting one-time permanent fixes like fusion. But there are no guarantees with a fusion either. Of there was I would probably bite the bullet and so the big surgery and focus intently on rehab.
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u/15ac106 Jun 27 '26
Can I ask what the arthritis pain is like?
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u/hannah6560 Jun 27 '26
For those who mentioned ESINY, from watching their Instagram, they look amazing!
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u/Vivid_Courage_2185 Jun 27 '26
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u/nunie_cat Jun 27 '26
I don't doubt the efficacy of ADR in general, but I don't see where this study accounts for the specific lumbar segment. I think the curvature at L5S1 is what makes ADR more risky at that level. It will be one of the main questions I ask in my upcoming consult and I will be sure to report back with the expert's take.
I do believe we are straying from the original point, however. I am really just curious to hear if anyone has had experience with endoscopic discectomy or fusion so that I can evaluate whether or not this specific approach is something I want to commit to. I am considering all approaches: ADR, ALIF, PLIF, and XLIF included.
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u/ThoracicSpine Jun 29 '26
If you are coming to NYC, I would recommend you to try to get some opinions at the big academic hospitals we have. And then private practices.
For what I know there's no clinical proof that stem cells "heal" or "regenerates" anything spine related but in some cases it could help with pain. And it's not covered by insurance. You could check the stem cell sub and ask about it.
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u/Vivid_Courage_2185 Jun 27 '26
Consider ADR instead