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Spine Treatments

Endoscopic Spine Surgery

As life expectancy increases and spinal diseases become more common, endoscopic spine surgery is becoming more important, especially for elderly patients with spinal disease. It can now be used to treat many degenerative spine conditions, including large, herniated discs and spinal stenosis. Many studies show that endoscopic spine surgery can be safely used to treat spine conditions in the neck, upper back, and lower back, including tumors, trauma, and deformities.

Dr. Ball has performed minimally invasive spine surgery and endoscopic spine surgery for more than two decades and has educated other spine surgeons about minimally invasive techniques for the spine. Minimally invasive surgery allows Dr. Ball to use specific surgical techniques that limit the size and number of incisions needed during a surgical procedure. Less trauma to the tissues results in less pain, less blood loss, and quicker recovery times.

Endoscopic spine surgery is the next level of minimally invasive spinal surgery. It has expanded in use due to recent improvements in endoscopic instruments, including the endoscope. This makes it more applicable to a wider range of spinal problems and allows personalizing surgery to meet each patient’s specific needs.

  • Reduced trauma to soft tissues
  • Reduced blood loss
  • Less postoperative pain
  • Reduced need for general anesthesia and the side effects of anesthesia
  • Shorter recovery
  • Reduced scarring

While benefits are significant, endoscopic spine surgery still carries the risks associated with other surgical procedures, including infection, bleeding, damage to nerves, and sometimes inadequate relief of symptoms.

Endoscopic spine surgery uses specialized instruments and a small camera, or endoscope, which allows Dr. Ball to access the spine through a single incision, typically less than one inch long. The endoscope transmits images of the spinal anatomy to a monitor, which Dr. Ball uses to guide the procedure. Specialized instruments are passed through the endoscope or additional small incisions to perform the necessary surgical interventions, such as removing herniated disc material, decompressing nerve roots, and stabilizing spinal joints.

Endoscopic spine surgery is designed to reduce damage to the surrounding muscles and tissues, leading to faster recovery times and less postoperative pain than traditional open spine surgery.

These are examples of some applications.

  • Lumbar spinal fusion – many clinical studies have shown successful outcomes with endoscopic lumbar spinal fusion.
  • Endoscopic techniques are now used for both anterior and posterior approaches.
  • Thoracic spinal surgery, while not very common, typically involves extensive tissue trauma and extended intensive care. Full endoscopic thoracic spine surgery has overcome many of the complications of this type of spine surgery.

Endoscopic spine surgery has a steep learning curve. It involves using real-time scans and navigation, which requires advanced surgical skills that aid in increased safety and accuracy.

Endoscopic spine surgery is now applied to the whole spine, including the cervical and thoracic spine. It has become a major technique with significant advantages. Dr. Hieu Ball is an expert in endoscopic spine surgery.

Contact Dr. Hieu Ball to schedule a consultation at his San Ramon. He offers a full range of treatments for neck pain. Dr. Ball offers state-of-the-art patient-centered care for patients with neck, mid-back, and low-back problems. He received his orthopedic and spine surgery residency and fellowship training at Harvard Medical School and UCLA-affiliated institutions. Education included training at Massachusetts General Hospital, Brigham and Women’s Hospital, and Boston Children’s Hospital. Dr. Ball is a double fellowship-trained orthopedic spine surgeon. He received a pediatric spine fellowship at Boston Children’s Hospital and a second adult spine fellowship at UCLA. Dr. Ball offers minimally invasive spine care, and many procedures often may be performed on an outpatient basis in an ambulatory surgical center.


  • Gadjradj PS, Fiani B, et al. Expanding indications of full endoscopic spine surgery. J Spine Surg. 2023 Sep 22;9(3):229-232. doi: 10.21037/jss-23-65. Epub 2023 Jun 27. PMID: 37841778; PMCID: PMC10570651.
  • Kwon H, Park JY. The Role and Future of Endoscopic Spine Surgery: A Narrative Review. Neurospine. 2023 Mar;20(1):43-55. doi: 10.14245/ns.2346236.118. Epub 2023 Mar 31. PMID: 37016853; PMCID: PMC10080412.
At a Glance

Dr. Hieu Ball

  • Double fellowship-trained orthopedic
  • Orthopedic surgery residency at Harvard Medical School
  • Over 20 years of spine surgery experience
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