The goal of minimally invasive spine surgery (MISS) is to achieve outcomes equivalent to those of open surgery while minimizing muscle dissection, disruption of ligament attachment sites and collateral damage to soft tissues. In general, minimally invasive spine surgery (MIS) surgery is performed to stabilize the vertebral bones and spinal joints and/or relieve pressure being applied to the spinal nerves — often a result of conditions such as a spinal instability, bone spurs, herniated discs, scoliosis or spinal tumors.
As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. Because of the reduced trauma to the muscles and soft tissues (compared to open procedures), the potential benefits are:
- Better cosmetic results from smaller skin incisions (sometimes as small as 2 centimeters)
- Less blood loss from surgery
- Reduced risk of muscle damage since less or no cutting of the muscle is required
- Reduced risk of infection and postoperative pain
- Faster recovery from surgery and less rehabilitation required
- Diminished reliance on pain medications after surgery
Conditions treated using MIS procedures are:
- Degenerative disc disease
- Herniated disc
- Lumbar spinal stenosis
- Spinal deformities such as scoliosis
- Spinal infections
- Spinal instability
- Vertebral compression fractures
- Spinal Tumors
Minimally Invasive Spine Surgery Procedure:
Because the spinal nerves, vertebrae and discs are located deep inside the body, any approach to gain access to the spinal area requires moving the muscle tissue out of the way. In general, this is facilitated by utilizing a small incision and guiding instruments and/or microscopic video cameras through these incisions. Contrary to popular belief, lasers are very rarely used in MIS surgeries.
Common MIS surgery treatment options include:
Spinal discs are essentially elastic rings with soft material inside that serve as cushions between the vertebral bones. If the elastic ring becomes weakened, the soft tissue inside can extrude — or herniate — outside of the elastic ring. The herniated disc material can compress the nerves passing by, thus causing pain. If surgical treatment is recommended to trim or remove the herniated disc, it may be possible to perform this procedure with MIS surgery using tubular dilators and a microscope or endoscope.
2). Spinal decompression:
Spinal stenosis, which is a narrowing of the vertebral canal, is a common condition that can result in compression of the nerves. This can produce a variety of symptoms, including pain, numbness and muscle weakness. If surgery is recommended, it may be possible to remove the bone and soft tissues causing the nerve compression through an MIS approach using tubular dilators and a microscope or endoscope. The more common decompressive procedures include laminectomy and foraminotomy.
3). Transforaminal Lumbar Interbody Fusion (TLIF):
This is a technique that is performed for patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease and recurrent disc herniation. The procedure is performed from the back (posterior) with the patient on his or her stomach. Utilizing two small incisions, screws and rods are placed between two or more vertebral levels. The intervertebral disc is removed and a cage filled with bone is placed in that void with the goal of stabilizing the levels affected.
As with any surgical procedure, no matter how minimal, there are certain risks associated that include but are not limited to:
- Possible adverse reaction to the anesthetic
- Unexpected blood loss during the procedure
- Localized infections, no matter how small the incision area
And, though uncommon, there is always a small chance that the initial MIS surgery cannot be completed, requiring either a second procedure or full open surgery.