Why Patients Travel Over 308.4 Miles for Endoscopic Spine Surgery

Medically Reviewed by Board Certified Orthopaedic Spine Surgeon Dean C. Perfetti, MD, MPH

Quick Answer

Endoscopic spine surgery treats certain spine problems, such as a herniated disc pressing on a nerve, through an incision often under an inch long. A 2025 study of the first 100 patients at a New York City endoscopic spine center found they traveled an average of 308.4 miles for care, and patients who needed a repeat spine surgery traveled the farthest. Part of the reason is access: relatively few surgeons perform this technique. Whether it fits a specific spine problem depends on what is causing the symptoms, which a spine surgeon sorts out by comparing the exam with imaging.

When back or leg pain makes it hard to walk, sleep, work, or drive, it makes sense to look past the closest office for answers. Some people have already tried medication, injections, or physical therapy. Others have been told a larger open surgery is their only option and want to know whether a smaller one is possible.

Endoscopic spine surgery uses a thin camera, called an endoscope, and small tools passed through a narrow tube to reach the spine. It is one option among several, and it suits some spine problems better than others. You will learn what the 308-mile number shows, which problems the surgery treats, how it compares with traditional surgery, and what to ask before traveling for an evaluation.

At a Glance

• In a 2025 New York study, patients traveled an average of 308.4 miles for endoscopic spine surgery, and those needing a repeat surgery traveled the farthest.
• The surgery is used most often for a herniated disc or a narrowed spinal canal that is pressing on a nerve.
• For a herniated disc in the low back, studies show leg pain results similar to traditional surgery, with fewer wound problems and an earlier return to work on average.
• It is not a good match for every spine problem, such as a spine that slips out of place or problems at several levels.
• Somers Orthopaedics offers endoscopic, traditional, and non-surgical spine care at offices in New York and Connecticut.

What Does the 308-Mile Finding Mean?

The 308-mile figure comes from a 2025 study of the first 100 patients treated at a specialty endoscopic spine center in New York City. On average, those patients lived 308.4 miles away, and some came from other states and other countries. A handful of very long trips pushed that average up, so many patients lived much closer.

Patients who needed a second operation after an earlier spine surgery traveled significantly farther than first-time patients, and almost one in three surgeries in the study was a repeat surgery. People seem most willing to travel when an earlier treatment did not solve the problem, or when few surgeons nearby offer the technique they want.

For patients in Westchester, Putnam, Dutchess, and Orange counties, the Hudson Valley, and Western Connecticut, exploring endoscopic spine surgery does not necessarily mean traveling into Manhattan. Somers Orthopaedics offers access to endoscopic spine care closer to home with Dr. Dean Perfetti, giving patients in the region another option when considering minimally invasive spine treatment.

What Is Endoscopic Spine Surgery?

Endoscopic spine surgery is a minimally invasive procedure that uses a small camera, called an endoscope, to show the surgeon the problem area on a screen. The surgeon passes small instruments through the same narrow opening to remove what is pressing on a nerve.

The surgery is most often used when something is pressing on a nerve. A herniated disc happens when the soft center of one of the cushions between the spine bones pushes out and presses on a nearby nerve. Spinal stenosis is a narrowing of the spaces the nerves travel through, often from bone spurs, thickened ligaments, or a bulging disc. Either one can cause sciatica, which is pain, tingling, or numbness that runs from the low back down the leg.

"Endoscopic" describes how the surgeon sees and reaches the spine, not one specific operation. Several procedures can be done this way, from removing part of a herniated disc to widening a narrowed opening where a nerve leaves the spine.

Why Would Someone Travel for Endoscopic Spine Surgery?

Patients usually travel for endoscopic spine surgery because they want a surgeon who performs it to look at their case. Many have already tried non-surgical care, heard different opinions, or been told a larger operation is their only option.

Common reasons patients consider travel include:

• Pain has not improved with non-surgical care: It helps to know whether the imaging actually explains the symptoms before deciding on any surgery.
• Leg or arm symptoms are affecting daily life: Pain, tingling, or weakness that travels into a limb often points to a pinched nerve, which is the main problem endoscopic surgery treats.
• A larger surgery was recommended: Some patients want to know whether a smaller approach can treat the same problem.
• Recovery time matters: People with physical jobs or young children at home often weigh how long they will need to limit lifting and work.
• An earlier surgery did not solve the problem: In the 308-mile study, patients needing a repeat surgery traveled the farthest.

Before any surgery is planned, the most useful question is what is causing the symptoms. The answer decides whether endoscopic surgery, another type of surgery, or non-surgical care makes the most sense.

What Symptoms Often Lead Patients to Seek a Spine Specialist?

Patients often see a spine specialist when pain, numbness, tingling, weakness, or stiffness starts getting in the way of everyday life. Symptoms that travel from the back into the buttock, leg, or foot often come from an irritated nerve, which is usually called sciatica.

A spine specialist may evaluate symptoms such as:

• Back pain with leg pain, numbness, or tingling
• Neck pain with arm pain, hand numbness, or weakness
• Pain that affects walking, standing, driving, or sleeping
• Symptoms that continue despite physical therapy, medication, or injections
• Weakness, balance changes, or reduced function

These symptoms do not automatically mean surgery is needed, and many spine problems get better with non-surgical care. When symptoms last, get worse, or keep returning, an exam and imaging can show whether a nerve is being pinched and where.

Sudden loss of bowel or bladder control, severe or worsening weakness, or symptoms after major trauma require urgent medical attention.

How Is Endoscopic Spine Surgery Different From Traditional Spine Surgery?

Endoscopic spine surgery reaches the spine through a narrow tube and uses a camera to see. Traditional open spine surgery uses a larger incision, and the surgeon moves muscle aside to see the area directly or through a microscope.

For a herniated disc in the low back, large reviews of randomized trials show the two approaches have similar results for leg pain. The endoscopic approach had fewer wound infections and wound-healing problems, and patients returned to work about three weeks sooner on average. It also used more X-ray during surgery and had a higher rate of temporary burning or tingling in the leg.

Some spine problems are a poor match for endoscopic surgery. A spine that shifts out of place, a significant curve, problems at several levels, infection, tumors, or major health risks may call for a different plan. The surgeon chooses the approach based on safety, anatomy, and what needs to be repaired.

Who Might Be a Candidate for Endoscopic Spine Surgery?

A patient may be a candidate when the exam and imaging point to one specific problem that can be reached safely through a small opening. This often includes some herniated discs, spinal stenosis, and narrowing where a nerve exits the spine.

Candidacy depends on several factors:

• Where the problem is located in the spine
• Whether imaging matches the patient's symptoms
• Whether non-surgical care has been tried or remains appropriate
• The patient's overall health, other medical conditions, and activity goals
• Whether the problem can be reached safely through a small opening
• Whether another approach would be safer or more effective

Imaging alone is not enough. A scan can show disc or joint changes that are not causing any symptoms. The exam connects where the pain, numbness, or weakness is felt with what the scan shows.

How Somers Orthopaedics Supports Spine Care in New York and Connecticut

Somers Orthopaedic Surgery & Sports Medicine Group offers endoscopic spine surgery along with traditional surgical and non-surgical spine care. Dean C. Perfetti, MD, MPH, is a fellowship-trained orthopaedic spine surgeon who treats conditions of the neck, mid back, and low back and sees patients in Mount Kisco, Carmel, Newburgh, and Danbury.

Dr. Perfetti performed the first fully endoscopic microdiscectomy at Northwell Health's Northern Westchester Hospital and has published work on endoscopic techniques for the low back. Because he also performs traditional and motion-preserving spine surgery, an evaluation is not built around a single procedure.

This gives patients in the Hudson Valley and Western Connecticut a way to ask about endoscopic spine surgery without starting in Manhattan. It can also help patients who want a second opinion after being told they need a larger spine operation.

Key Takeaways

• Patients often travel for endoscopic spine surgery because relatively few surgeons perform it.
• In one New York study, patients who needed a repeat spine surgery traveled the farthest for endoscopic care.
• For a herniated disc, endoscopic and traditional surgery have similar leg pain results, but the endoscopic approach has fewer wound problems.
• Candidacy depends on where the problem is, whether imaging matches the symptoms, and overall health.
• Loss of bowel or bladder control, severe or worsening weakness, or symptoms after major trauma need emergency care.

Frequently Asked Questions

What is endoscopic spine surgery?

Endoscopic spine surgery is a minimally invasive technique that uses a small camera and instruments passed through a narrow tube to treat certain spine problems. It is used most often for herniated discs and spinal stenosis that press on a nerve.

Why would patients travel for endoscopic spine surgery?

Patients travel because relatively few surgeons perform endoscopic spine surgery. Many want a second opinion after being told they need a larger operation, or after an earlier surgery did not solve the problem.

Is endoscopic spine surgery safer than open spine surgery?

Endoscopic spine surgery has lower rates of wound infection than traditional surgery for a herniated disc, but it is still surgery and has its own risks. These include temporary burning or tingling in the leg, a tear in the thin lining around the nerves, and the disc herniating again. The safest approach depends on the diagnosis, anatomy, and overall health.

Can endoscopic spine surgery treat a herniated disc?

Yes, endoscopic surgery is used for many herniated discs, especially when disc material is pressing on a nerve and the symptoms match the imaging. Where the herniation sits and how large it is decide whether it can be reached safely this way.

Is endoscopic spine surgery outpatient?

Many endoscopic spine procedures are done on an outpatient basis, meaning the patient goes home the same day. A small incision does not mean the disc and nerve heal faster underneath, so limits on lifting, bending, and twisting still apply for a period after surgery.

When should I see a spine specialist for sciatica or nerve pain?

It is reasonable to see a spine specialist when sciatica, numbness, tingling, or weakness lasts, gets worse, or affects walking, work, or sleep. Sudden loss of bowel or bladder control or severe weakness needs emergency care.

Looking Into Endoscopic Spine Surgery Closer to Home

If back, neck, arm, or leg symptoms are changing how you walk, sleep, or work, Somers Orthopaedic Surgery & Sports Medicine Group can help you understand what is causing them and whether endoscopic spine surgery, another type of surgery, or non-surgical care fits your situation. Call 845-278-8400 or request an appointment to schedule a spine evaluation in New York or Connecticut.

*This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Talk with a qualified healthcare provider about your specific symptoms and treatment options.