Endoscopic and minimally invasive spine stabilisation

Professor Iakiv Fishchenko is a spine surgeon and Doctor of Medical Sciences. His practice includes endoscopic decompression, endoscopic interbody fusion and percutaneous screw fixation when indicated. He consults and operates in Kyiv at the National Institute of Traumatology and Orthopaedics of the National Academy of Medical Sciences of Ukraine and the private MedProfi clinic.

Iakiv Fishchenko has been in clinical practice since 2004. Since 2018, he has personally performed more than 3,000 endoscopic spine operations in total. He coauthored a study on interbody fusion, wrote an atlas of biportal endoscopy used to train spine surgeons around the world, and has taught endoscopic spine surgery since 2019.

Slippage on an image alone does not determine treatment. Symptoms, neural findings and previous treatment are assessed. Non-surgical options are discussed at consultation.

No. Decompression may be sufficient for some patients with degenerative spondylolisthesis. The need for fixation is assessed individually.

It is an interbody fusion technique performed through an endoscopic approach: neural structures are decompressed, the disc space is prepared under camera guidance, a cage and bone graft material are inserted, and percutaneous screws complete the construct. A study involving the professor describes the biportal UBLIF technique. Compared with an open approach, it offers several significant advantages: less muscle trauma, less blood loss and less early pain.

Yes. Send current investigations and the records of your previous operation. Professor Fishchenko analyses why the expected result was not achieved, identifies the cause of persistent symptoms and considers possible next steps. The need for another operation is assessed from the investigation findings.

Send complete imaging, a description of your symptoms and the proposed treatment plan to the professor on Telegram, Viber or WhatsApp. Consultation can address the objectives, extent and alternatives to the procedure.

Cost depends on the scope of surgery, implants and treatment location. Recovery is discussed in relation to the planned procedure and your condition. The treatment plan and estimate are clarified with the administrator after consultation.

His scientific profile is available on ORCID. A selected interbody fusion paper is linked in the Research section of this page. Lectures and videos are available on the SpinaNetUa YouTube channel. His full professional profile and atlas of biportal endoscopy are available through the links below.

Contact the professor on Telegram @ProfFishchenko or on Viber / WhatsApp at +380503808725. Information and in-person appointments: 094-821-08-30. Preliminary review helps plan the next step; a final decision requires clinical assessment.

TPF is the Ukrainian abbreviation for pedicle-screw fixation: screws are inserted through the vertebral pedicles and connected with rods. In our interbody fusion technique, a cage and bone graft material are always added. The cage provides support between the vertebral bodies and distributes the load together with the screws. Inadequate fusion and overloading of the construct can lead to implant loosening or damage.

Yes. When stabilisation is necessary, the professor combines endoscopic decompression with endoscopic cage insertion and percutaneous screw fixation. Decompression releases neural structures, the cage and screws stabilise the segment, and bone graft material provides the conditions for fusion. This approach is described in the professor’s patient guide.

In the endoscopic interbody fusion performed by Professor Fishchenko, a cage is an essential component of the construct. It maintains the space between vertebrae, provides support and, together with bone graft material, creates the conditions for fusion. We use only porous titanium: its structure supports bone ingrowth; specific models have shown less subsidence than PEEK, including in osteoporosis.

We use quality branded implants from leading international manufacturers and exclusively porous titanium cages. The professor considers anatomy, bone quality, mechanical loads and the extent of fixation to select the appropriate system, implant size and shape.

Provide the anaesthetist with a complete medication list and information about allergies and chronic conditions. It is particularly important to report anticoagulants and antiplatelet medicines. Do not change them yourself: the doctors agree on a plan based on their indications and risks. Required tests and fasting instructions before anaesthesia are determined individually.

A brace is not needed by every patient. Whether it is necessary and how long to use it depend on the operation and the condition of the spine. The surgeon makes this decision; exercises and activity levels are also agreed with the rehabilitation team.

With an uncomplicated recovery, short journeys as a passenger are usually possible around one week after surgery, and longer journeys around two weeks, after agreement with the professor. Longer trips require breaks for walking. Driving, air travel and return to work or sport are discussed separately, taking account of healing, pain control and safe movement; activity is increased gradually.

Routine removal is not planned after every fusion. It may be considered for specific indications, such as infection or a problem with the construct. The decision takes account of symptoms, imaging and the state of bone fusion.

Yes. We use implants that allow MRI under the manufacturer’s specified conditions. Before the scan, show your discharge summary or implant identification documents to the MRI team so they can check the conditions for the specific system and scanner.

Fusion eliminates movement in the segments intended to unite. With pronounced degenerative changes, these segments often already have limited movement before surgery, so many patients do not notice a substantial additional restriction in everyday life. The effect depends on the number and level of the segments and the condition of the rest of the spine; expected changes and rehabilitation are discussed before surgery.

The main difference is the approach. The camera and instruments work through small openings, the cage is inserted endoscopically and the screws percutaneously. This limits muscle trauma and offers significant advantages in blood loss and early pain. Small wounds create favourable conditions for healing. However, fusion creates bone union with either approach, and the risks of surgery remain.

A small approach preserves soft tissues, reduces blood loss and early postoperative pain, and creates the conditions for early mobilisation. According to Professor Fishchenko’s assessment, an endoscopic operation can be performed in 97% of cases of degenerative lumbar disease that require stabilisation. The duration of surgery and the pace of rehabilitation depend on the extent of the operation and the patient’s condition.