Endoscopic Spine Surgery for Central Valley Patients

One office, patients from across the Valley

Central Valley Advanced Spine is the practice of Dr. Devan Higginbotham, a fellowship-trained orthopaedic spine surgeon. We have one office, in Fresno, California. We do not run clinics in other towns. Patients from other cities come to Fresno for the consultation, for surgery and for follow-up visits.

Fresno sits near the center of the San Joaquin Valley, and Highway 99 connects it to most of the larger Valley cities. Clovis borders Fresno. Visalia is under an hour away. Modesto and Bakersfield are each about two hours by car. The city pages below describe the trip, local imaging options and planning tips for each place.

What endoscopic spine surgery is

The surgeon makes a small cut in the skin and guides a narrow tube to the nerve that is being pinched. A thin camera with a light, called an endoscope, goes through the tube and shows a magnified view on a screen. Tiny instruments pass through a channel in the scope to remove the material pinching the nerve, which is most often a disc fragment and sometimes a bone spur. The muscles next to the spine are moved aside rather than cut, which is the main reason people look for this approach. Our complete endoscopic spine surgery guide covers the two approaches, recovery ranges and risks.

Who it may help

Endoscopic surgery is best suited to a limited problem, usually one or two pinched nerves. Common reasons include:

• A herniated lumbar disc causing leg pain, known as sciatica
• Narrowing where the nerve exits the spine, a form of lumbar stenosis
• In selected cases, a disc herniation in the neck that presses on one nerve root

It is usually not used for an unstable spine, a large curve or problems at many levels. Most people try therapy, activity changes and time before surgery comes up.

Why patients travel to Fresno for it

Not every spine practice offers endoscopic surgery. It takes specific equipment and training. In 2025 Dr. Higginbotham performed what was reported as the first endoscopic spine surgery in Fresno. Endoscopic surgery is one of the four procedures the practice focuses on, along with cervical disc replacement for Valley patients, navigated spine surgery and adult deformity correction.

Because many endoscopic operations are outpatient, patients from farther cities often go home the same day. For a two-hour drive, some people prefer to stay one night nearby before heading home. We can talk through what makes sense for you.

Planning from outside Fresno

1. Send imaging

   Ask your imaging center to send the MRI images and the report before your first visit.

2. Consultation

   Exam and imaging review in Fresno. Bring a list of medicines and past treatments.

3. Surgery day

   Plan a driver. Recline the passenger seat and stop to walk on a long ride home.

4. Follow-up

   A wound check in the first weeks, then visits to follow nerve recovery.

Pre-surgery lab work can often be done with your own doctor near home, and therapy after surgery can often happen at a clinic in your own town. See how to prepare for spine surgery for a full checklist.

Choose your city

Distances are approximate, city center to city center, by the usual highway route.

• Fresno Our office
• Clovis about 9 miles
• Visalia about 44 miles
• Modesto about 95 miles
• Bakersfield about 109 miles

Patients from other Valley towns, such as Madera, Merced, Hanford, Tulare and Porterville, are welcome too. Call us and we will help plan the trip. You can also see every location page in one place.

Questions from Valley patients