Mininally Invasive Spine Surgery: Top 5 Questions Answered
Minimally invasive techniques have changed the way many spine surgeries are performed today. Some procedures once involving large incisions are now performed through coin-sized half-inch incisions. Instead of spending days in the hospital, some patients are released home within 24 hours!
- What is minimally invasive spine surgery?
- How is minimally invasive spine surgery better than open spine surgery?
- Can all spinal problems be corrected using minimally invasive procedures?
- Which spine procedures may be performed using minimally invasive techniques?
- How do I know if I'm a candidate for minimally invasive spine surgery?
What is minimally invasive spine surgery?
Minimally invasive spine surgery, or keyhole surgery, is performed through one or more half-inch skin incisions. Some surgeons refer to the small incisions as portals. Where the incisions are made depends on how the surgeon needs to approach, or gain access to the spine. There are 3 basic approaches: from the front (anterior), back (posterior), or side (translateral).
The surgeon uses an endoscope during the procedure. An endoscope is similar to a narrow tube with an eyepiece and camera attachment. The surgeon looks through the eyepiece to see a magnified image of the surgical field (patient's anatomy). In real time, the camera transmits the same image to a video monitor. Everyone in the operating room can view the operation on the monitor.
With the patient fully sedated under general anesthesia, the spine surgery is performed through the endoscope by advancing it gently through one of the incisions. Special instruments designed for delicate endoscopic use are passed through the endoscope. When the procedure is completed, the small incisions are sutured and dressed.
How is minimally invasive spine surgery better than open spine surgery?
Minimally invasive spine surgery offers many potential advantages including:
- Fewer days in the hospital
- Reduced blood loss
- Reduced postoperative pain
- Smaller incisions reduce scarring and are cosmetically more appealing
- Newer instrument designs enable tissues to be separated in ways that minimize muscle fiber and soft tissue damage
- Rehabilitation is often easier and patients return to normal activities faster
Can all spinal problems be corrected using minimally invasive procedures?
Not every spine problem is treated this way, nor is minimally invasive spine surgery the best choice for all patients.
Minimally invasive spine surgery often is performed to decompress spinal nerves or the spinal cord, stabilize the spine, or to correct spinal deformity. Spine surgeons regularly treat herniated discs, spinal stenosis, types of spinal deformity, and vertebral compression fractures using minimally invasive surgical techniques.
Which spine procedures may be performed using minimally invasive techniques?
Minimally invasive procedures include:
Discectomy (microdiscectomy): Surgical removal of all or part of the disc
Foraminotomy: Surgically enlarging the spinal nerve pathway (foramen) to remove pressure on a nerve
Kyphoplasty: Stabilizes vertebral compression fractures with medical-grade cement, restores vertebral body height, and reduces deformity
Laminectomy: Removes part or all the lamina (thin semi-circle like arch of bone behind the vertebral body) to reduce pressure on the spinal cord
Laminotomy: Makes a hole in the lamina to create more space for the spinal cord; allows access to the structures beneath the lamina
Nucleoplasty: Treats bulging discs by removing tissue from the center of the disc
Spinal fusion: Stabilizes the spine using bone graft and instrumentation
Vertebroplasty: Stabilizes vertebral compression fractures with medical-grade cement and reduces deformity
How do I know if I'm a candidate for minimally invasive spine surgery?
Your spine surgeon is your best resource. He or she can answer your questions and help you to make well-informed choices about your healthcare.