A new ultra-minimally invasive spinal surgery being performed in Calgary is allowing some patients to go home within hours instead of days. The procedure, known as percutaneous endoscopic transforaminal lumbar interbody fusion, or TLIF, is part of the Calgary Endoscopic Spine Surgery Research and Advancement program, or CESSRA, at Foothills Medical Centre. Nearly 100 patients have undergone the surgery in Alberta since it was introduced 16 months ago. Foothills is one of only a handful of health-care facilities in Canada offering the technique. Traditional spinal fusion typically requires a 10-centimetre incision. The newer approach uses five small punctures, each about the diameter of a pencil, allowing surgeons to remove a damaged disc and insert hardware to stabilize the spine using an endoscopic camera. Since the CESSRA program was introduced in January 2025, the average post-operative hospital stay has been four to six hours, compared with about three days for traditional spinal fusion. Average blood loss during the procedure is roughly one-tenth of what is typically seen. Dr. Michael Yang, a neurosurgeon at Foothills Medical Centre who leads the program, says the technique reduces surgical impact. “By not having to open the patient up, we’re not disrupting muscle and bones to reach our target, meaning there’s far less blood loss, less pain, and patients can start their recovery almost immediately,” Yang said. He says the approach can also reduce strain on the health-care system by shifting more procedures to day surgery. “The benefit of all this is that we also save hospital beds. Because we’re doing surgery as day operations, we save inpatient hospital care beds as well as resources, so that other Calgarians who need access to these resources can be can access these resources in a more timely manner,” he said. Dr. Michael Yang, a neurosurgeon at Foothills Medical Centre who leads the program, says broader adoption of the technique is limited by the training required to perform it. “Technology, certainly that’s a barrier, but it’s also requires a special skill set to do this operation. Because, imagine if you were new to open surgery; everything’s open. You can see everything, now you’re just using a seven millimeter camera to do the surgery itself, so the learning curve is also there,” Yang said. To push surgeons to invest that time learning a new technique, Yang says patients will need to start asking for it. “I think more education for patients to drive that conversation with the surgeon will be imperative,” he said. Dale Bingham, a 72-year-old from Red Deer, was among the first patients treated through the program. He says years of back and leg pain had made even simple movement difficult, particularly in the morning. He says the improvement was immediate after surgery, with no return of the nerve pain that had previously limited his mobility. “I had zero back pain, zero leg pain.” Said Bingham. “This has changed my life so much for the better.” In the months since, Bingham says he has returned to an active routine that includes daily walking, gym workouts and golf. “I went back to the my gym. After six weeks, was doing elliptical, treadmill. After two months, I started doing weight machines, lighting weights and stuff like that.” “I’ve been hitting golf balls for the last month,” he added. “I played 18 holes on Saturday and nine holes on Sunday.” His partner, Laura Bourne, says she was struck by how quickly he was able to move after the procedure. “I was shocked, actually. As soon as he was out of recovery, I went to see him in the hospital, and he was up and moving, eating, doing everything,” Bourne said. The CESSRA program is supported by the Calgary Health Foundation, which has set a fundraising goal of more than $9 million over five years to help expand access to the procedure. Some of the implants used in the procedure have yet to be approved by Health Canada, meaning doctors must apply for approval for each case. Yang says he hopes that will change, noting he has never had an application denied.
