With recent advances in technology, it is now possible to perform spine surgery through minimally invasive techniques. Minimally invasive spine surgery (MISS) allows for surgery to be done with much smaller incisions than the traditional “open surgery” which typically requires a long incision to access and view the anatomy. By avoiding these long incisions and damage to the muscles of the back and neck, there is less pain and faster recovery for the patient.
A recommendation for spine surgery usually occurs after a period of conservative treatment involving medications, physical therapy, and injections have failed to provide the patient with adequate relief of symptoms. Once surgery is decided upon, there is a process to determine if a patient is a candidate for minimal spine surgery. Not every patient meets the criteria for these techniques; however, some procedures that can be performed with a minimal approach include the removal of herniated disks, spinal fusions, and the treatment of deformities, fractures, and infection.
Traditional spine surgery usually requires a 5-6 inch incision with extensive dissection and retraction of muscle tissue. This is a common source of postoperative pain and can also lead to significant blood loss. Hospital stays following this type of surgery can last up to 5 days or longer with an overall recovery period of several months.
Minimally invasive spine surgery was developed to treat certain spine problems and delivers the advantage of smaller incisions, less bleeding, less injury to the muscles and other structures of the spine, and shorter hospital stays. Some of these procedures can even be performed as same-day surgery with the patient going home after a short recovery period.
These procedures are performed through tubular style retractors and special tools that are designed to fit through these retractors. These retractors are placed in the body with the assistance of real-time X-ray. They are passed through the skin and soft tissues down to the spinal column and then held in place during the procedure. The retractor holds the muscles open to allow the surgeon to see the small area in the spine where the problem exists. Sometimes more than one retractor is required to perform the procedure. The surgeon then uses the appropriate instruments to remove bone or disk material through the retractor and is able to place any device, such as screws or rods, if a fusion of the spine is necessary. In order to assist in visualization, a surgeon may choose to use a microscope to magnify the view through the retractor during the surgery. After the surgery is completed, the retractor is removed, minimizing the damage to the muscles.
Back pain and spine problems are very common. Patients should always undergo appropriate nonsurgical treatment before considering surgery. However, if surgery is indicated, the option for minimally invasive spine surgery can make the recovery much easier. The technique is now available at the North Louisiana Orthopaedic & Sports Medicine Clinic.