What if there were a way to eliminate or significantly reduce your spine-related pain without the risks commonly associated with open surgery?
This is exactly what’s possible with what’s termed minimally invasive spine surgery (MISS). It’s an increasingly common approach to easing nerve pressure and/or stabilizing the spine that’s performed with techniques that achieve the same goals as open surgery.
MISS involves the use of smaller incisions, specialized instruments, live X-rays, and, with some procedures, surgical microscopes and even robotic technology.
Reasons for Minimally Invasive Spine Surgery
MISS is like any other type of spine surgery in that patients are normally urged to try non-surgical remedies like pain medication, NSAIDs, and various forms of physical therapy for 4-6 months or more before considering surgery.
However, if symptoms get worse or continue even after exploring other pain management options, MISS may be discussed. The list of conditions that may be addressed with minimally invasive techniques has grown significantly over the years to include:
- Disc herniation
- Spinal stenosis, scoliosis, and other abnormalities of the spine
- Defects affecting vertebrae or spinal joints
- Spinal instability caused by fractures, infections, or tumors
Before MISS Surgery
Prior to MISS, additional testing that can include image tests, nerve conduction studies, and other specialized tests may be done to further confirm a likely source of symptoms. Patients are also advised not to smoke prior to surgery. Blood thinners and other types of medication may also need to be temporarily stopped to prevent issues with bleeding and tissue healing.
During and After Minimally Invasive Spine Surgery
General or local anesthesia may be used with MISS. During most procedures, small incisions are made to access the affected part of the spine. One incision is usually for a special lighted tube with a camera attached that provides a clear view of the spine or the damaged disc. Another incision is for a tubular retractor, which is the device used to insert instruments and carry out the procedure. Additional visual guidance may be provided by a fluoroscopy – a real-time X-ray. A surgical microscope is used with some procedures. Other less invasive procedures have a special setup that includes a surgeon-controlled robotic device.
Some less invasive procedures are same-day operations, while others require a brief stay in a surgical center. Following MISS, there will be a need to avoid strenuous activities. Specific instructions will be given about bathing and resuming normal activities. Some patients may need to temporarily wear a back or neck brace to minimize movement and allow tissues to properly heal. Physical therapy is also commonly recommended post-surgery to help spine-supporting muscles regain strength.
Types of Minimally Invasive Spine Surgery
MISS is generally broken down into two broad categories: minimally invasive decompression surgery and minimally invasive stabilization surgery. Common procedures include:
- Anterior cervical discectomy and fusion (ACDF)
- Microdiscectomies, microlaminectomies, or microforaminotomies
- Tansforaminal lumbar interbody fusion and other less invasive approach to spinal fusion
Minimally invasive spine surgery can benefit many different patients of all age ranges with a wide range of spine-related issues. However, it’s not always the best option. For instance, traditional spine surgery may be the better choice if multiple levels of the spine need to be corrected, or if there are issues with access to the affected part of the backbone. Deciding factors typically include overall patient health and the nature of the problem affecting the spine.