What is MIS?
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MIS is an acronym for Minimally Invasive Spine Surgery. Other terms related to MIS are minimal access spine surgery, endoscopic spine surgery, or laser spine surgery. This spine surgery is minimally invasive because surgery is performed through one or more small incisions or punctures through which tubular retractors or an endoscope is inserted. MIS helps to reduce the risk of infection and decrease pain, facilitates faster recovery, and improves back muscle function.
- Tubular retractors spare cutting through muscles and soft tissues and minimize damage. Tubular retractors gently and progressively dilate and separate muscles and soft tissues to the operative field. Using specialized instruments and microscopic visualization, surgery is performed through the tube.
- Endoscopes are thin tubes with a light source and camera. The endoscope is inserted through a small stab / incision and positioned. Small instruments are passed through the endoscope to the surgical site where the surgeon performs the procedure. The endoscopic set up enables the surgeon to view the surgery on a monitor.
Surgery is performed through small tubular MIS retractors with special internal lighting
View down a tubular retractor (18mm diameter) with internal light source
Postoperative picture after a 3-level revision with instrumentation. White dressings are the MIS incisions. The purple line shows the old open incision from initial surgery.
By contrast, traditional open spine surgery requires a long incision and cutting through muscles, which causes soft tissue damage and means a longer recovery (see panel below).
Open surgery means longer incisions and muscle injury
MIS: Patient Benefits
Patients with high expectations to return to work and active play find minimally invasive spine surgery offers many benefits. Even patients who are elderly, obese, or have a complex spinal problem, such as deformity or trauma may also benefit from MIS surgery.
- Muscles and soft tissues are spared
- Risk of postoperative infection is decreased
- Some procedures can be performed as outpatient surgery
- Blood loss is reduced
- Patients experience less postoperative pain
- Reduced need for postoperative pain medication
- Time hospitalized is reduced
- Small incisions, cosmetically more appealing
- Recovery is faster
- Patients return to regular activities sooner
Conditions Treated with MIS
Not so long ago, all spine surgery was performed as an open procedure. Significant advances in surgical instruments, techniques, image-guided surgery, biotechnology (i.e. bone graft), devices, and implants have made MIS safe and effective in surgical spine care. The following spinal problems are routinely treated using MIS:
- Cervical and lumbar herniated discs
- Degenerative scoliosis
- Cervical and lumbar spinal stenosis
Other disorders treated using MIS technology include infection, trauma (i.e. spinal fracture), and tumors. MIS enables surgeons to decompress, fuse and stabilize, and correct deformity.
MIS procedures and techniques are safe and effective for treating many different spinal disorders. These procedures are very technical and should be performed by surgeons with training and experience in MIS techniques. Your spine surgeon will be pleased to explain how MIS may benefit you.