Q: I have had many epidural steroid injections and am probably headed for surgery of the neck and low back. I have been reading about AccuraScope, a minimally invasive procedure and want to know the efficacy of this new catheter scope type alternative. I have been through most alternative treatments, MRIs and other diagnostic procedures but am concerned about major surgery.
A: Millions of individuals suffer with debilitating back pain every day. Depending on the diagnosis received, surgery is, at times, the only option, especially in the case of a herniated disc that can cause back, buttock and leg pain. Do you have disc prolapse, or might you have spinal stenosis?
It appears the latest trend in laser spine surgery is with the Accurascope DND (Discectomy and Neural Decompression) unit pioneered by Dr. Lawrence B. Rothstein for the purpose of diagnosing, treating and alleviating chronic pain. The AccuraScope allows for a minimally invasive procedure for pain management that is used to diagnose and treat inter-vertebral lumbar discs, spinal stenosis and other chronic back pain diagnoses. It utilizes X-ray for guidance as an endoscopic fiberoptic instrument and camera is inserted through a minute incision in the skin and into a natural opening at the base of the spine. The physician can examine the discs of the lower back and determine if there is any herniation, bulging, scar tissue or other abnormality. He or she can shrink the damaged disc(s), treat the spinal stenosis or scar tissue, and relieve the pressure that exists on the spinal nerve(s).
The surgery is accomplished in about 30 minutes on an out-patient basis and is purported to reduce the need for additional procedures. Because of the size of the incision, it is closed with one single stitch or simply covered with an adhesive bandage. The patient is taken to a recovery area and is generally discharged about one hour following surgery. The manufacturer claims patients walk the same day as the surgery and begin physical therapy exercises the day following. Having reported this presumed glowing report, my research indicates that minimally invasive disc removal techniques are no better than standard surgical methods.
I would be remiss if I didn’t report a different view from that of the manufacturer that appears on the internet on hubpages.com, a site comprised of writers with opinions who are neither medical doctors nor are they all experts in the field in which they have an opinion. According to one report, the procedure is performed by pain management physicians and anesthesiologists, not board certified spine or orthopedic surgeons. The device, trademarked as Accurascope cannot be found in the FDA’s website as ever being approved. In January 2011 a federal complaint was filed in the U.S. District Court to halt the sale of the video-guided catheters. Despite this, North American Spine, headquartered in Texas, continues to promote and perform the non-invasive Accurascope DND laser spinal surgery, despite serious safety questions and lawsuits from former patients who have been left maimed for life. At one point Dr. Rothstein had 19 active medical malpractice cases pending against him by former patients. The doctor has since claimed bankruptcy, temporarily halting the balance of the remaining medical malpractice cases against him. As an update, on April 12, 2013, Dr. Rothstein permanently surrendered his certificate to practice medicine and surgery to the State Medical Board of Ohio.
There are always negative comments out there on every subject known to mankind, but your health is critical. Therefore, I suggest you take my response to your surgeon for clarification. I can only report what I have read on this procedure and would never intentionally mis-direct anyone. If you feel you are being operated on by a qualified surgeon and if you can be assured everything is on the level, perhaps you will wish to proceed. However, if any question remains, pass it up and consider other options. I strongly urge you to seek a second opinion at a reputable medical center before making a commitment.
