Endoscopic spine surgery is a minimally invasive surgical technique that addresses spinal conditions while minimizing trauma to surrounding tissues. Unlike traditional open surgery, which requires larger incisions and more extensive dissection, endoscopic spine surgery uses small incisions and specialized instruments, including an endoscope, to visualize and treat the affected area. This helps accurately target spinal abnormalities, such as herniated discs, spinal stenosis, or nerve compressions, with minimal disruption to muscles and soft tissues.

Advantages of endoscopic spine surgery include:

• Reduced recovery times

• Less operative and postoperative pain

• Smaller incisions

Dr. Ju has undergone extensive training to deliver advanced care to his patients. He utilizes endoscopic technology to perform the following procedures:

Transforaminal Endoscopic Discectomy: A procedure for removing herniated disc material through a small incision using endoscopic tools.

Medial Branch Transection: A minimally invasive treatment for chronic back pain caused by facet joint issues.

Interlaminar Endoscopic Discectomy: A technique for removing herniated disc material in the lumbar spine through a small incision.

Microscopic tubular decompression is an alternative to a traditional open laminectomy or lumbar decompression. The goal is to decompress the painful nerve to reduce pain and disability from sciatica, numbness, tingling, and spinal stenosis. This is performed via a minimally invasive 1 inch incision with a small tubular retractor and microscopic instruments for a targeted strike. A high definition neurosurgical microscope is used for optimal visualization and safety. The following procedures can be performed via microscopic decompression:

• Partial laminectomy

• Microdiscectomy

• Foraminotomy

Artificial disc replacement is a surgical procedure to remove the diseased or damaged intervertebral disc and replace it with an artificial joint. Artificial disc replacement reduces or eliminates pain, restores spinal movement, and improves quality of life. Just like a hip or knee replacement, the discs of the spine can be replaced instead of fused.

Unlike spinal fusion surgery, artificial disc replacement allows the vertebral bones to move, to twist, and to bend. Thus, artificial disc replacement preserves range of motion in the spine.

Cervical Artificial Disc Replacement (CADR):
Surgical solution designed for patients with degenerative disc disease or disc herniations/nerve pinching in the neck. By preserving natural mobility and minimizing the risk of adjacent segment disease, CADR offers significant benefits such as reduced pain and improved function.

Lumbar Artificial Disc Replacement (LADR):
Surgery tailored for individuals experiencing degenerative disc disease, nerve pinching, or disc herniations in the lower back. Through its focus on restoring or maintaining lumbar spine motion, LADR provides benefits like pain relief, enhanced mobility, and a quicker recovery compared to fusion procedures.

Dr. Ju customizes each surgery to match each patient’s anatomy to the optimal disc replacement device, including:

• Prodisc C vivo

• Prodisc C SK

• Prodisc L

• Simplify

• Mobi-C

Many—but not all—people are candidates for artificial disc replacement surgery.

Spinal fusions are sometimes needed to reconstruct the spinal column - such as correct scoliosis and kyphosis (misaligned bones), stabilize unstable spinal segments (e.g. spondylolisthesis), and increase the space between the bones (for bone-on-bone degenerative disc disease).

Anterior Cervical Discectomy and Fusion (ACDF), also referred to as anterior cervical decompression, is a minimally invasive surgery to remove a herniated or degenerative disc in the neck. The procedure is performed through the front of the neck to give the surgeon better access to the spine and to provide the patient with less post-operative pain. This surgery is performed to alleviate pain, weakness, numbness and/or tingling caused by pressure on the spinal cord or nerve root. ACDF can be done on one or multiple levels of the cervical spine.

Anterior Lumbar Interbody Fusion (ALIF) is used to treat lower back pain and nerve pain for degenerative spine conditions. During the procedure, the surgeon uses a minimally invasive approach to the front of spine through the abdomen instead of the traditional large incision in the lower back. A 3D printed titanium spacer is inserted into the damaged disc space. This will help to restore the normal disc height and alignment and open up the nerve tunnels to alleviate nerve pain. ALIF is sometimes combined with a minimally invasive posterior approach to provide the patient with more stabilization for healing.

Transforaminal lumbar interbody fusion (TLIF) is a type of surgical spinal fusion that is used to restore disc height and permanently fuse damaged or misaligned vertebrae, eliminating abnormal movement and reducing pain and nerve pressure. TLIF is often recommended to treat back or leg pain caused by conditions such as spondylolisthesis, degenerative disc disease or recurrent disc herniations. Performed through the posterior (back) of the spine with two minimally invasive small incisions, the damaged disc is partially removed and an implant is inserted in the empty disc space to restore normal disc height and take pressure off the nerve roots. Surgical hardware such as pedicle screws and rods as well as bone graft are placed on the sides of the spine to further stabilize and fuse the spine.

Extreme lateral interbody fusion (XLIF) is a minimally invasive fusion procedure to reconstruct the lumbar spine due to abnormal shifting (e.g. spondylolisthesis) or bone-on-bone disc collapse. The procedure is performed through a small incisions on the patient’s side, avoiding and sparing the major muscles of the back, as well as ligaments and bones. Using advanced nerve monitoring technology and special instruments, the damaged disc is removed and a 3D printed spacer is placed into the disc space. This will help realign the vertebral bones and lift pressure from nerve roots that are pinched. Depending on the patient’s condition, screws, plates and rods may also be used to support and stabilize the fusion.

Minimally invasive posterior cervical fusion (PCF) is a minimally invasive way to stabilize the cervical spine through the back of the neck. This is most often done for patients who have persistent pain after prior anterior fusion (ACDF) due to incomplete bone healing, also called pseudoarthrosis. This surgery is performed through two small one-inch incisions on the back of the neck to put small metal spacers into the joints of the cervical spine to further stabilize the segment. This avoids the traditional large open midline incision and most patients can go home the same day.

Robotic spine surgery is a way to accurately place spinal implants in a minimally invasive fashion. Using a 3D CT scan, the robot can be used to place screws and guide other instrumentation placement with utmost accuracy and minimize soft tissue trauma and incision length.

Dr. Ju uses the Globus Excelsius Robot

Pain from sacroiliac joint dysfunction can be felt in the lower back or spine, buttocks, pelvis, groin, or sometimes in the legs. People with SI joint dysfunction can experience pain and impaired function. It's important to note that SI joint pain symptoms can be similar to those of other conditions of the lumbar spine, pelvis, and hip, and you will need an SI joint examination to properly diagnose the origin of the pain.

If you have been diagnosed with SI joint dysfunction, which can lead to one or both of the SI joints becoming painful, we first recommend nonsurgical treatments, such as medications, physical therapy, or steroid injections. If those non-surgical treatments fail to provide relief, minimally invasive SI joint fusion is a safe and effective procedure to relieve SI joint pain.

Minimally invasive surgery (MIS) or SI joint fusion requires a small 2 inch surgical incision. The procedure typically involves inserting three 3D printed screw implants across the SI joint to fuse and stabilize it. Most patients can go home the same day.

Dr. Ju uses the SI-bone system, who makes the only clinically proven minimally invasive solution for SI joint fusion, available since 2009.