Selected Podcast
Endoscopic Spine Procedure (BESS)
If you ever feel like you can't bend down to pick up something or suffering from back pain due to a herniated disc, an endoscopic spine procedure may be the solution for you. Dr. Tyler Carson discusses endoscopic spine surgery, the possible benefits, and more.
Featured Speaker:
Tyler Carson, DO
Dr. Carson was born and raised in Oceanside CA. He attended UCLA where he completed a B.S. in Materials Engineering in 2003. After graduation Dr. Carson spent 5 years at Northrop Grumman Space Technology in Redondo Beach working in development of composite structures for satellite and space systems. Dr. Carson then went on to attend medical school at Western University in Pomona graduating with a D.O. degree in 2012. He subsequently completed a Neurosurgery Residency in 2018 from Riverside University Health System in 2018 and spent an additional year completing a fellowship in complex and minimally invasive spine surgery at University of Tennessee in Memphis, TN. Transcription:
Intro: Progressive respectful, mentoring, compassionate. These are the values of Palmdale Regional Medical Center. And now we proudly present Palmdale Regional Radio.
Maggie McKay (Host): This is Palmdale Regional Radio. I'm Maggie McKay. If you ever feel like you can't bend down to pick up something you've dropped or you're suffering due to back pain from something like a herniated disc, an endoscopics spine procedure, maybe the solution joining me today is Dr. Tyler Carson, a neurosurgeon at Palmdale regional medical center. Thank you so much for being with us today, Dr. Carson
Dr Tyler Carson: Thank you for having me Maggie.
Maggie McKay (Host): LEt's dig right in what is endoscopics epine surgery
Dr Tyler Carson: Well, endoscopic spine surgery is, basically a minimally invasive method for performing a surgery that, in past has been, performed by an open technique or making a larger incision And dissecting more tissue. Essentially the most minimally invasive way to access the spine.
Maggie McKay (Host): Who would be a candidate for minimally invasive spinal surgery?
Dr Tyler Carson: Yeah. So anybody that has been suffering from, leg pain or radiculopathy or sciatica from disc herniations that are causing compression of their nerves in their low back, would be, a great candidate for this. And ideally, this allows us to, minimally invasively access, one level or even two levels of the spine through a few small incisions in the back.
Maggie McKay (Host): So are there limitations to the conventional endoscopic spinal surgery, as opposed to this method?
Dr Tyler Carson: Right. So there's a couple of endoscopic methods. And the method that I use is what's called a dual access or dual portal method where we're basically making two small, incisions to place a camera through one and instruments through the other. And that allows us to triangulate to a position in the spine and bypass all of the, tissue dissection that we would normally need to do on the way in. Another endoscopic method is, what they call uni portal or a single incision. And, both the camera and instruments go through the same incision. and, the benefit of that is it's a single incision, but the downside of that is that the instruments always come into the spine at the same angle. And, this doesn't really allow for as much freedom of movement of the instrument as the dual, access method.
Maggie McKay (Host): And when it comes to a minimally invasive approach, how does that improve the surgery?
Dr Tyler Carson: Minimally invasive approach, allows us to cause less damage to the tissue. That means patients would heal up faster from this have less pain after its surgery. And, there's less chance of an infection due to less damage to tissue. so a lot of these, endoscopic procedures can be done as an outpatient procedure where the patient goes home the same day.
Maggie McKay (Host): Wow. That's impressive. Is that the same story with the traditional method?
Dr Tyler Carson: So typically with the traditional method, most of the time, the patient will be staying overnight for at least the night in the hospital and there's variations that people may call minimally invasive spine surgery. A couple of other methods for minimally invasive spine surgery include making a smaller incision and using specific retract to, move muscle out of the way. Sometimes a tubularor, sometimes retractor blades. these are both considered minimally invasive methods, but endoscopic is truly the most minimally invasive method. We don't have to cut through muscle we just place the cameras through the muscle and get down to the bottom of the spine where we need to do the surgery.
Maggie McKay (Host): So I imagine recovery is a lot faster?
Dr Tyler Carson: It is, you know, the patients who've had this done and my experience are up and walking, 30 minutes after the surgery and don't really experience anything in the
Maggie McKay (Host): So they're better than they were before.
Dr Tyler Carson: Absolutely.
Maggie McKay (Host): Is there physical therapy or medication involved after they get.
Dr Tyler Carson: Patients will, usually get started with physical therapy a week or two after the surgery, and it sort of depends on. their symptoms were before the surgery, especially if they're having weakness, and need to work on strengthening their, lower extremity muscles again, after the surgery, because they've been dealing with it for so long, then we'll get them started with physical therapy, And pain wise, most of the time people get by with just a Tylenol for the first few days after the surgery.
Maggie McKay (Host): And so take us back maybe 20 years when somebody had the similar kind of procedure, the traditional method, how long would recovery have been then?
Dr Tyler Carson: The traditional method, basically involved making an incision down the middle of your back, and. Disconnecting the muscles from the, bones and the spine and moving the muscles out of the way to get down to the spine. And, then once you perform the surgery on the spine, suturing, the muscle and the skin back together. That takes a good six weeks to heal up, from that surgery, as opposed to this, we're basically, closing the incisions up with bandaid and that's it.
Maggie McKay (Host): That's amazing. and Dr. Carson is age a factor when it comes to who's a candidate for endoscopic spine surgery?
Dr Tyler Carson: So, age is, a factor only in the sense of, the patient's. Ability to undergo anesthesia. So, most of these, procedures we do under general anesthesia though, I have done, one, with, spinal anesthesia where the patient was awake for the surgery. But, this is a great option, especially for elderly patients. It's much, more minimally invasive, very minimal to no blood loss. Very quick recovery for them.
Maggie McKay (Host): Are there any side effects?
Dr Tyler Carson: The side effects or risks with the surgery are similar to risks with, open spine surgery, with the exception of much less chance of infection, and much less chance of significant bleeding. There's risks to injury, to the nerves or injury to the surrounding muscle or bone, but that is very minimal when we're, placing just small instruments down there. And, the main risk with any surgery really Is the patient undergoing anesthesia for that surgery. So we always have to take that into consideration.
Maggie McKay (Host): Is it still a case that this procedure is only being done two places, one of which is Palmdale Regional Medical Canter?
Dr Tyler Carson: In the Southern California area, there's only a few people doing this particular technique with the dual portal. and Palmdale is one of them.
Maggie McKay (Host): That's great. So what does the future of endoscopics spine surgery look like?
Dr Tyler Carson: The future of endoscopic spine surgery, we foresee as becoming, what has happened with, endoscopic general surgery cases, which is moving more and more towards robotic assisted surgery, performing more and more of the larger fusion type surgeries through the endoscope. And augmenting this with, virtual reality, to allow us to, bring in the patient's, preoperative imaging and, give the surgeon complete visualization of the spine through these two small openings.
Maggie McKay (Host): Doctor, is there anything else you'd like to share?
Dr Tyler Carson: I would just like to say that, this is a great new technique. The successes that I've seen with patients have been really wonderful. And, if you've been considering spine surgery, but have been told never have spine surgery because you'll never be the same again, this is the technique for you. This causes very, very minimal, tissue, damage. And you'll heal up from this very quickly.
Maggie McKay (Host): Thank you so much for being here and sharing your expertise, Dr. Carson, this has been so helpful and educational.
Dr Tyler Carson: Thank you for having me.
Maggie McKay (Host): And that concludes another episode of Palmdale Regional Radio. With Palmdale Regional Medical Center, please visit our This email address is being protected from spambots. You need JavaScript enabled to view it. for more information, and to get connected with one of our providers. Please remember to subscribe great and review this podcast and all the other Palmdale Regional Medical Center podcasts. For more health tips and updates, follow us on your social channels. Please share your social media and be sure to check out all the other interesting podcasts in our library.
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.
I'm your host? Maggie McKay be well.
Intro: Progressive respectful, mentoring, compassionate. These are the values of Palmdale Regional Medical Center. And now we proudly present Palmdale Regional Radio.
Maggie McKay (Host): This is Palmdale Regional Radio. I'm Maggie McKay. If you ever feel like you can't bend down to pick up something you've dropped or you're suffering due to back pain from something like a herniated disc, an endoscopics spine procedure, maybe the solution joining me today is Dr. Tyler Carson, a neurosurgeon at Palmdale regional medical center. Thank you so much for being with us today, Dr. Carson
Dr Tyler Carson: Thank you for having me Maggie.
Maggie McKay (Host): LEt's dig right in what is endoscopics epine surgery
Dr Tyler Carson: Well, endoscopic spine surgery is, basically a minimally invasive method for performing a surgery that, in past has been, performed by an open technique or making a larger incision And dissecting more tissue. Essentially the most minimally invasive way to access the spine.
Maggie McKay (Host): Who would be a candidate for minimally invasive spinal surgery?
Dr Tyler Carson: Yeah. So anybody that has been suffering from, leg pain or radiculopathy or sciatica from disc herniations that are causing compression of their nerves in their low back, would be, a great candidate for this. And ideally, this allows us to, minimally invasively access, one level or even two levels of the spine through a few small incisions in the back.
Maggie McKay (Host): So are there limitations to the conventional endoscopic spinal surgery, as opposed to this method?
Dr Tyler Carson: Right. So there's a couple of endoscopic methods. And the method that I use is what's called a dual access or dual portal method where we're basically making two small, incisions to place a camera through one and instruments through the other. And that allows us to triangulate to a position in the spine and bypass all of the, tissue dissection that we would normally need to do on the way in. Another endoscopic method is, what they call uni portal or a single incision. And, both the camera and instruments go through the same incision. and, the benefit of that is it's a single incision, but the downside of that is that the instruments always come into the spine at the same angle. And, this doesn't really allow for as much freedom of movement of the instrument as the dual, access method.
Maggie McKay (Host): And when it comes to a minimally invasive approach, how does that improve the surgery?
Dr Tyler Carson: Minimally invasive approach, allows us to cause less damage to the tissue. That means patients would heal up faster from this have less pain after its surgery. And, there's less chance of an infection due to less damage to tissue. so a lot of these, endoscopic procedures can be done as an outpatient procedure where the patient goes home the same day.
Maggie McKay (Host): Wow. That's impressive. Is that the same story with the traditional method?
Dr Tyler Carson: So typically with the traditional method, most of the time, the patient will be staying overnight for at least the night in the hospital and there's variations that people may call minimally invasive spine surgery. A couple of other methods for minimally invasive spine surgery include making a smaller incision and using specific retract to, move muscle out of the way. Sometimes a tubularor, sometimes retractor blades. these are both considered minimally invasive methods, but endoscopic is truly the most minimally invasive method. We don't have to cut through muscle we just place the cameras through the muscle and get down to the bottom of the spine where we need to do the surgery.
Maggie McKay (Host): So I imagine recovery is a lot faster?
Dr Tyler Carson: It is, you know, the patients who've had this done and my experience are up and walking, 30 minutes after the surgery and don't really experience anything in the
Maggie McKay (Host): So they're better than they were before.
Dr Tyler Carson: Absolutely.
Maggie McKay (Host): Is there physical therapy or medication involved after they get.
Dr Tyler Carson: Patients will, usually get started with physical therapy a week or two after the surgery, and it sort of depends on. their symptoms were before the surgery, especially if they're having weakness, and need to work on strengthening their, lower extremity muscles again, after the surgery, because they've been dealing with it for so long, then we'll get them started with physical therapy, And pain wise, most of the time people get by with just a Tylenol for the first few days after the surgery.
Maggie McKay (Host): And so take us back maybe 20 years when somebody had the similar kind of procedure, the traditional method, how long would recovery have been then?
Dr Tyler Carson: The traditional method, basically involved making an incision down the middle of your back, and. Disconnecting the muscles from the, bones and the spine and moving the muscles out of the way to get down to the spine. And, then once you perform the surgery on the spine, suturing, the muscle and the skin back together. That takes a good six weeks to heal up, from that surgery, as opposed to this, we're basically, closing the incisions up with bandaid and that's it.
Maggie McKay (Host): That's amazing. and Dr. Carson is age a factor when it comes to who's a candidate for endoscopic spine surgery?
Dr Tyler Carson: So, age is, a factor only in the sense of, the patient's. Ability to undergo anesthesia. So, most of these, procedures we do under general anesthesia though, I have done, one, with, spinal anesthesia where the patient was awake for the surgery. But, this is a great option, especially for elderly patients. It's much, more minimally invasive, very minimal to no blood loss. Very quick recovery for them.
Maggie McKay (Host): Are there any side effects?
Dr Tyler Carson: The side effects or risks with the surgery are similar to risks with, open spine surgery, with the exception of much less chance of infection, and much less chance of significant bleeding. There's risks to injury, to the nerves or injury to the surrounding muscle or bone, but that is very minimal when we're, placing just small instruments down there. And, the main risk with any surgery really Is the patient undergoing anesthesia for that surgery. So we always have to take that into consideration.
Maggie McKay (Host): Is it still a case that this procedure is only being done two places, one of which is Palmdale Regional Medical Canter?
Dr Tyler Carson: In the Southern California area, there's only a few people doing this particular technique with the dual portal. and Palmdale is one of them.
Maggie McKay (Host): That's great. So what does the future of endoscopics spine surgery look like?
Dr Tyler Carson: The future of endoscopic spine surgery, we foresee as becoming, what has happened with, endoscopic general surgery cases, which is moving more and more towards robotic assisted surgery, performing more and more of the larger fusion type surgeries through the endoscope. And augmenting this with, virtual reality, to allow us to, bring in the patient's, preoperative imaging and, give the surgeon complete visualization of the spine through these two small openings.
Maggie McKay (Host): Doctor, is there anything else you'd like to share?
Dr Tyler Carson: I would just like to say that, this is a great new technique. The successes that I've seen with patients have been really wonderful. And, if you've been considering spine surgery, but have been told never have spine surgery because you'll never be the same again, this is the technique for you. This causes very, very minimal, tissue, damage. And you'll heal up from this very quickly.
Maggie McKay (Host): Thank you so much for being here and sharing your expertise, Dr. Carson, this has been so helpful and educational.
Dr Tyler Carson: Thank you for having me.
Maggie McKay (Host): And that concludes another episode of Palmdale Regional Radio. With Palmdale Regional Medical Center, please visit our This email address is being protected from spambots. You need JavaScript enabled to view it. for more information, and to get connected with one of our providers. Please remember to subscribe great and review this podcast and all the other Palmdale Regional Medical Center podcasts. For more health tips and updates, follow us on your social channels. Please share your social media and be sure to check out all the other interesting podcasts in our library.
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians.
Individual results may vary. There are risks associated with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive surgery is right for you.
I'm your host? Maggie McKay be well.