The Joimax Procedure

New endoscopic spine surgery in Massachusetts for disc herniation.

Dr. Houle performing an endoscopic discectomy

Neurosurgeons of Cape Cod and Cape Cod Hospital  are the first and only group in Massachusetts offering the transforaminal endoscopic approach for discectomy and foraminotomy. This minimally invasive technique is an excellent option for patients with disc herniations and/or spinal stenosis. The procedure is done quite differently from traditional spine surgery. A small incision is made in the side of the patient, and the entire procedure is performed through a small scope. Most of the original disc is preserved and only the damaged portions of the disc are removed. The patient is awake but drowsy and able to respond during surgery.

This technique has been performed in Europe for nearly a decade and has finally arrived in Massachusetts. The surgery can be performed on patients with prior spine surgery that have a recurrence of disc herniation, far lateral discs, extruded discs, and spinal stenosis.

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A large sequestered disc fragment removed from patient by Dr. Houle

Minimally invasive spinal column surgery has developed into an alternative and reliable treatment procedure for a range of spinal column disorders. The surgical technique is used especially for discectomy, for treating herniated discs. In the 1970s, doctors in Europe began performing surgery with cannula specially designed for percutaneous dorsolateral discectomy, achieving a documented success rate of 75% with their technique. In the 80s, the principle of mechanical nucleotomy was further advanced by other physicians. Thanks to the combination of a growing body of endoscopic knowledge of the anatomy of the intra- and extraforaminal areas, the radiological determination of orientation points for the working zone around the dorsolateral area of the anulus by Kambin and the availability of smaller endoscopes, lateral access became possible. The TESSYS® method and joimax® technology combines the access methods and techniques applied by multiple users, as published in numerous articles, and has been applied successfully in thousands of procedures

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MRI revealing foraminal protrusion causing leg pain

International medical literature reports a success rate of 75- 85% for percutaneous discectomy. Many centers achieve approximately 90% success rates by using microscopic surgeries for herniated discs. Using the endoscopical TESSYS® method for removing herniated disc problems results in a success rate of over 93% , as documented in 1-year, 2-year and most recently 3-year studies. The early recurrence rate can be maintained at under 4%. The success rate for patients with recurring herniated disc incidents is over 86%

The TESSYS® surgical technique enables high-precision treatment to be performed whilst minimizing tissue trauma. This results in minor wound pain and very little scar tissue. In addition, spine stability is unimpaired. Because this technique utilizes conscious sedation, it is suitable for all age groups and is an outpatient procedure, allowing the patient to leave the hospital on the same day for a faster return to everyday life.

Please see the video below of Dr. Houle performing an endoscopic discectomy.  If you would like to be considered for this operation, please click the button to go to our online second opinion page.

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