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Stitchless Spine Surgery

Updated: Nov 18, 2020

Transforaminal Endoscopic Spine Surgery under Local Anesthesia (TSSULA)

Written by Bansal Gaurav, MBBS, MS, MCh (AIIMS), IFAANS (USA)

TSSULA (Transforaminal Endoscopic spine surgery under LA) is an advanced, novel procedure developed to treat Disc related problems in lumbar and thoracic spine. TSSULA is a paradigm shift in the way disc problems are treated. With TSSULA , an array of disc lesions ranging from chronic annular tears to disc prolapse to migrated discs can be successfully treated.

There is a lot of difference between the traditional open spine surgery, the traditional minimally invasive spine surgery and the true stitchless spine surgery under local anesthesia.

Endoscopic Spine Surgery under Local Anesthesia

Endoscopic Spine Surgery is a type of state-of-the-art surgery that uses small tubular system or micro incisions, assisted with an endoscope for visualization. This type of Minimally-Invasive Spine Surgery (MISS) provides patients with quicker recovery and less pain than traditional spine surgery.

Endoscopic Spine Surgery preserves normal spine mobility because the spine is not fused with screws and rods. With experienced hands, most of procedures takes less than one hour and the patient gets back to walk around in only a few hours.

Our Endoscopic Spine Surgery is a true minimally invasive procedure that has revolutionized the treatment of back and neck pain. If you're searching for long lasting pain relief, we can help.

What are the advantages of this type of procedure?

Advantages of our industry leading minimally invasive endoscopic and fusion alternative surgeries include the following:

  • Microscopic incision (less than 0.5 cm)

  • Minimal or no blood loss

  • Immediate recovery

  • Reduced pain meds

  • Preservation of spinal mobility

  • Mostly local anesthesia

  • Same day surgery

  • High success rates

  • Improved quality of life

  • No removal of muscle or bone


TSSULA is performed under local anaesthesia. However in apprehensive patients, single shot Epidural anaesthesia can be given.

A 0.5-1 cm incision is made over lower back through which a needle is inserted at an angle into the disc space, a guide wire is then introduced through the needle. Over the guide wire a cannula is introduced into the disc space through which a very small endoscope is inserted and under direct vision the surgery is performed.

The duration of surgery is usually 1 hr — 1.5 hrs depending on the severity of disc prolapse. The disc fragments are removed with graspers introduced through the endoscope.

The patient can be made to walk immediately if done under LA or after 6hrs if done under EA. He/ She can be discharged the very same day.

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