Peter B. Derman, MD

I spent Saturday in Charlotte teaching endoscopic spine surgery to a fantastic group of residents, fellows and their senior surgeon.

Education, clinical care, research and product development are all avenues for me to express my passion for endoscopic spine surgery. Together they drive the positive impact this field is having on patients’ lives.

There is clear momentum building — it’s awesome to see the next generation so eager to explore what’s possible!

Thanks to for bringing me out and hosting another great course. 👏

“𝗪𝗶𝗹𝗹 𝗜 𝗯𝗲 𝗮𝗯𝗹𝗲 𝘁𝗼 𝗯𝗲 𝗮𝗰𝘁𝗶𝘃𝗲 𝗮𝗳𝘁𝗲𝗿 𝘀𝗽𝗶𝗻𝗲 𝘀𝘂𝗿𝗴𝗲𝗿𝘆?” 🤸‍♂️

I hear this question often. My answer: 𝗢𝗳 𝗰𝗼𝘂𝗿𝘀𝗲. 𝗧𝗵𝗮𝘁 𝗶𝘀 𝘁𝗵𝗲 𝘄𝗵𝗼𝗹𝗲 𝗽𝗼𝗶𝗻𝘁!

Take Valencia, for example. She was suffering from severe sciatica due to spinal stenosis (nerve compression) in the setting of two-level mobile spondylolisthesis — where the spinal bones slide back and forth. After non-surgical options didn’t provide relief, we performed a minimally invasive L2-4 fusion.

“What… You did a fusion, Derman?!” 😳

While my bias is strongly toward 𝗺𝗼𝘁𝗶𝗼𝗻 𝗽𝗿𝗲𝘀𝗲𝗿𝘃𝗮𝘁𝗶𝗼𝗻 (last month, only 1 out of my 27 surgeries was a fusion), it’s important not to be dogmatic. When the anatomy needs to be stabilized to address the root cause and fix the pain, a thoughtful, focused fusion can be the right tool for the job.

𝗜𝗻 𝗩𝗮𝗹𝗲𝗻𝗰𝗶𝗮’𝘀 𝘄𝗼𝗿𝗱𝘀:
“What differentiated Dr. Derman was he explained all the options... it felt like he partnered with me. Now I can sleep, exercise, and bend without pain or fear of pain.”

Today? She is back at Pilates, living a pain-free, active lifestyle. ✨

𝗦𝘂𝗿𝗴𝗲𝗿𝘆 𝗶𝘀𝗻’𝘁 𝗮𝗯𝗼𝘂𝘁 𝗹𝗶𝗺𝗶𝘁𝗮𝘁𝗶𝗼𝗻𝘀; 𝗶𝘁’𝘀 𝗮𝗯𝗼𝘂𝘁 𝗿𝗲𝘀𝘁𝗼𝗿𝗶𝗻𝗴 𝗳𝘂𝗻𝗰𝘁𝗶𝗼𝗻. 𝗪𝗵𝗮𝘁’𝘀 𝘁𝗵𝗲 𝗼𝗻𝗲 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆 𝘆𝗼𝘂’𝗱 𝗻𝗲𝘃𝗲𝗿 𝘄𝗮𝗻𝘁 𝘁𝗼 𝗹𝗶𝘃𝗲 𝘄𝗶𝘁𝗵𝗼𝘂𝘁? 👇

I’m excited to serve as Co-Chair for the 4th Endoscopic Spine Surgery Symposium this July 17-18 at the Seattle Science Foundation.

This isn’t just another lecture series — it is a deep dive into the future of our field. We’ve brought together a powerhouse faculty of national leaders to lead two days of hands-on cadaveric training and engaging didactic sessions.

This is the place to be for current and aspiring endoscopists. Come join us in Seattle, and let’s push the boundaries of endoscopic spine surgery together!

Grab your spot here:
https://www.seattlesciencefoundation.org/courses/4th-endo-spine-symposium

𝗗𝗼 𝗻𝗼𝗻-𝘀𝘂𝗿𝗴𝗶𝗰𝗮𝗹 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁𝘀 “𝗰𝘂𝗿𝗲” 𝗱𝗶𝘀𝗰 𝗵𝗲𝗿𝗻𝗶𝗮𝘁𝗶𝗼𝗻𝘀?

Technically, no — but they provide the essential window for the body to heal itself. Approximately 75% of disc herniations naturally shrink or completely disappear within a year.

While non-surgical options like physical therapy, non-narcotic medications, and epidural steroid injections are often viewed as “band-aids,” they serve a vital purpose: they manage symptoms and buy time. By the time the effects of an injection wear off, the body may have already dissolved the herniated material on its own.

𝗖𝗮𝘀𝗲 𝗦𝘁𝘂𝗱𝘆:
An active young woman came to me with severe pain shooting down her leg.
• 𝙇𝙚𝙛𝙩 𝙈𝙍𝙄: A sizable herniated disc in her lower back was causing substantial nerve compression.
• 𝙏𝙧𝙚𝙖𝙩𝙢𝙚𝙣𝙩: She underwent a stepwise course of conservative care rather than jumping to surgery.
• 𝙍𝙞𝙜𝙝𝙩 𝙈𝙍𝙄 (𝟭 𝘆𝗲𝗮𝗿 𝗹𝗮𝘁𝗲𝗿): Her herniation has shrunken dramatically. Her sciatica is gone, and she avoided the operating room entirely.

𝗧𝗵𝗲 𝗕𝗼𝘁𝘁𝗼𝗺 𝗟𝗶𝗻𝗲
The least invasive surgery is still no surgery, which is why it’s important to consider non-operative measures first. However, you don’t have to suffer for a year to see if you’ll get better. If non-surgical treatments aren’t providing enough pain control to let you live your life, an ultra-minimally invasive endoscopic procedure could get you there in an hour. 😉