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What Is Minimally Invasive Spine Surgery?

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Minimally invasive spine surgery (MISS) uses advanced technology and innovative techniques to treat back pain and neck pain caused by a variety of spinal disorders.

Some of the spinal conditions MISS can treat are:

MISS has been around since the 1980s, but today it's one of the most rapidly advancing surgical procedures. Through computer-assisted technology and highly specialized tools, minimally invasive surgery is an attractive option for patients who want a quicker recovery after surgery, less post-operative pain, and smaller incisions.

Defined as any spinal surgery that specifically attempts to minimize tissue damage,1 MISS may be a less risky, less invasive option compared to traditional open spine surgery. Although there are advantages of MISS, the goals of MISS procedures are the same as open traditional procedures.

The 2 main goals of minimally invasive spine surgery are:

  • Decompression: This is used to take pressure off (to decompress) your spinal cord or nerve roots. That pressure can cause pinched nerves and pain. The goal of this procedure is to relieve the pressure and reduce your pain.
  • Stabilization: Sometimes a mobile segment can be the source of pain or abnormal movement can cause pain. When this happens, a stabilizing surgery may be needed. This is typically a fusion, often done with instrumentation.

There are 3 main minimally invasive spine surgery techniques:

  • Mini-open: This is similar to an open procedure, but has fewer risks, such as less blood loss during surgery and less risk of infection because the incision is much smaller. Advances in visualization have made mini-open procedures possible.
  • Tubular: This surgery involves a tubular retractor, which acts as a tunnel that passes through your back muscles to access your spine. MISS with a tubular retractor is commonly referred to as a "muscle-splitting" approach. Compared to open spine surgery, there is less muscle damage and less blood loss when using a tubular retractor.
  • Endoscopic: This spine surgery uses a tiny video camera called an endoscope—which is smaller than a dime—to pass through small surgical incisions (usually less than 2 cm) to access your spine. According to the American Association of Neurological Surgeons, this procedure is commonly referred to as a "keyhole surgery" because an endoscope guides surgeons by showing them an internal view of your body on screens in the operating room. However, there are only a few spine surgeries that use endoscopes.

These 3 types of MISS can be used in specific spine surgeries, such as discectomy, foraminotomy, and laminectomy and laminotomy.

Sometimes a fluoroscope is used during minimally invasive spine surgery. Fluoroscopes are x-ray machines used to guide your surgeon during your procedure. They give your surgeon the best views of your spine.

Keep in mind, though, that surgery should be a last resort for treating your pain caused by a spine condition.

If you've tried non-surgical treatments, such as pain medications, rest, and physical therapy, in the last 6 to 12 months and they're not working for you, then you may want to consider spine surgery, and minimally invasive spine surgery may be an option for you.

Updated on: 06/24/11
Jason M. Highsmith, MD
This article was reviewed by Jason M. Highsmith, MD.
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