Where the visits happen
All of our appointments and surgeries are in Fresno. We do not have an office in Visalia or anywhere in Tulare County. From downtown Visalia, the trip is about 44 miles: west on Highway 198 to Highway 99, then north through Kingsburg and Selma into Fresno. Most people make it in 45 to 50 minutes.
That is short enough that most visits are a morning or an afternoon, not a whole day. Kaweah Health Medical Center in Visalia is the largest hospital in Tulare and Kings counties and has its own orthopedic and neurosurgery services. Plenty of Visalia residents get their spine care there. If you are looking at Fresno, you may want a second opinion or a direct answer about whether an endoscopic approach fits your problem.
What endoscopic surgery is
A surgeon places a narrow tube through a small cut in the skin and guides it to the pinched nerve. A camera called an endoscope goes down the tube and shows a magnified, lit view on a monitor. Small tools pass through the same tube to take out the disc fragment or bone that is pressing on the nerve.
Because the tube spreads the back muscles instead of cutting them, the goal is less damage to the tissue around the spine. There are still real risks, including infection, bleeding, a tear in the lining around the nerves, nerve injury and the disc herniating again. Our main endoscopic spine surgery page goes over the details.
In 2025, Dr. Higginbotham performed what was reported as Fresno's first endoscopic spine surgery.
Who in Visalia it may help
Most people who ask about this surgery have a disc in the low back pressing on a nerve root. The result is sciatica, which is pain, burning or numbness running from the buttock down the leg. Others have nerve pressure from lumbar stenosis at one spot. Some selected neck problems can be treated this way as well, such as a disc herniation in the cervical spine.
It is usually not used for an unstable spine, a curve or problems at several levels. If that is what we find, we will explain the other choices.
Warehouse, farm and county jobs
Visalia has become a distribution hub. The Visalia Industrial Park is home to large centers for Amazon, UPS and other companies, and those jobs involve lifting, carrying and long shifts on concrete floors. The area is still built on farming too, with dairies, nut orchards and citrus. Many other people work for Kaweah Health, Tulare County or the school district.
A disc problem can happen to anyone, in any of those jobs. What people who lift for a living usually want to know is when they can go back. Some people return to light duty sooner after endoscopic surgery than after open surgery, but full lifting takes longer. We will set a plan with you based on your work.
Others simply want to get back to the things they do on weekends, like long walks or a trip up Highway 198 to hike in Sequoia National Park. Those are good goals to share at your visit, because they help us shape your recovery plan.
Planning a procedure from Visalia
- Records. Have your MRI images sent from Kaweah Health or your Visalia imaging center before the first visit. Bring a disc as a backup.
- Consultation. An exam, a review of your images and a talk about whether surgery is needed at all. With images in hand, this is usually a single visit.
- Surgery day. Dr. Higginbotham operates at Fresno Surgical Hospital, and many endoscopic procedures are outpatient. You will need a driver, and the ride home is under an hour.
- Follow-up. A few short trips to Fresno over the next weeks. Physical therapy, if you need it, can usually be done at a clinic in Visalia.
Because the drive is short, most Visalia patients do not need a hotel. If your surgery is very early or you live well outside the city, a night in Fresno before surgery is worth thinking about.
Visalia FAQ
Can I go home to Visalia the same day?
Many people do. It depends on the procedure and how you feel after surgery. We will tell you ahead of time if we expect you to stay overnight.
My MRI was done at Kaweah Health. Do I need a new one?
Often not. If it is recent and clear, we can use it. We ask for the images themselves so the surgeon can look at them directly.
When can I go back to a warehouse job?
It depends on your procedure, how you heal and how heavy the lifting is. Desk work often comes back sooner than heavy work. We will give you a written plan for your employer.
Is endoscopic surgery right for everyone with sciatica?
No. Many people with sciatica get better without surgery. When surgery is needed, the right approach depends on the imaging and exam.
Do you have a Visalia office?
No. All of our care is in Fresno. Call (559) 758-7119 with questions before you book.