Endoscopic decompression treats nerve compression — most often from lumbar canal stenosis — through a tiny portal using a high-definition endoscope. The thickened ligament and overgrown bone pressing on the nerves are removed under magnified vision while the muscles, midline structures and stability of the spine are preserved. For well-selected patients it offers the relief of traditional decompression with substantially less surgical trauma.
Who is a candidate
The typical candidate has leg pain, heaviness or tingling on walking (neurogenic claudication) from canal or lateral recess stenosis confirmed on MRI, persisting despite good conservative care. One- or two-level stenosis without significant instability suits the endoscopic approach best. Patients with unstable spondylolisthesis, severe multi-level disease or deformity are usually better served by other techniques — honest selection is what protects results.
How the procedure works
Through a sub-centimetre incision, a working tube is placed under X-ray guidance and the endoscope is introduced. Under continuous magnified vision, the surgeon removes the thickened ligamentum flavum and shaves the overgrown bone compressing the nerves — including, via the over-the-top technique, the opposite side through the same small portal. The nerves are visibly free at the end of the procedure.
Advantages over open decompression
Because the approach dilates rather than detaches the back muscles, patients typically experience less post-operative pain, minimal blood loss, a shorter hospital stay — often 24 hours — and faster return to daily activity. The midline bone and ligaments are preserved, which protects the spine's stability. For suitable anatomy, decompression quality matches open surgery in experienced hands.
Recovery timeline
Most patients walk within hours of surgery and go home the same or next day. Desk work is commonly resumed within one to two weeks. A graded rehabilitation programme from week two rebuilds core strength and walking endurance — many stenosis patients find their walking distance improves steadily over the following weeks as the nerves recover.
Consultation and candidacy assessment
Whether endoscopic decompression suits your stenosis depends on the MRI pattern, stability on standing X-rays and your examination. Dr. Arun Reddy M — fellowship-trained in endoscopic spine surgery — assesses candidacy at CARE Hospitals, HITEC City (Gachibowli) and the Madinaguda evening clinic. You can send your MRI through this website for a preliminary opinion.