Minimally Invasive Spine Surgery Center
Minimally invasive spine surgery (MISS) may be an option for patients who require a surgical procedure to treat a spine disorder (eg, herniated disc, spinal stenosis). At one time, all spine surgical procedures were performed as open surgery, which required long incisions to enable the surgeon to see a large area of the patient’s spinal anatomy. However, advancements in surgical techniques and instruments have made many of these surgeries to be performed through tiny incisions.
Is MIS Surgery always the best choice?
Not every type of spine surgery can or should be performed using a MIS technique. Like any type of surgery, MIS surgery offers patients and surgeons benefits with the potential for complications—the risk of a problem developing. Infection is one type of risk. Some patients have other medical problems such as cardiovascular disease, diabetes or osteoporosis. All current medical problems, including overall health, patient age, and functional ability are factors the surgeon carefully evaluates before a surgical recommendation is made. Fortunately, spine surgery is not often an urgent medical necessity—giving patients time to learn about their spine problem and treatment recommendations.
MIS Surgery Similar to Open Surgery in Some Ways
Preoperative imaging (eg, CT scan, MRI) helps the surgeon to plan the surgery. Depending on the diagnosis and area of the spine requiring surgical intervention, a MIS procedure may access the patient’s spine from the front of their body (anterior), rear (posterior), or side (lateral).
Special imaging (eg, fluoroscopy) is utilized by the surgeon and his or her team to visualize anatomical landmarks, guide instruments, and implant instrumentation (eg, interbody devices). Upon conclusion of the surgery, postoperative imaging is used to confirm placement of rods, screws, plates or other devices that may be used to stabilize the spine.
Unlike open surgery, many minimally invasive spine surgical procedures do not require cutting muscles or soft tissues. Rather retractors sequentially dilate the tissues—that means, the muscles and tissues are gently pulled aside as a series of dilation tubes of greater diameter are advanced into the operative site.
MIS Surgical Procedures
Many different types of spinal disorders may be treated using MIS surgical procedures. For example, a herniated or bulging disc may cause compression of a spinal nerve root resulting in inflammation and pain. The pain may radiate (travel) into a nearby arm or leg. Discectomy, a traditional open procedure, may now be performed as a microdiscectomy or microdecompression to remove disc matter pressing on a nerve. Decompression means to remove pressure from the nerve. Laminotomy and laminectomy are other procedures that decompress the spinal cord and/or nerve roots that exit the spine through the neuroforamen—nerve passageways on either side of the disc (between the upper and lower vertebral body). MIS surgeries may include spinal fusion and instrumentation.
How Patients May Benefit
Minimally invasive spine surgery may benefit a patient in many different ways. Of course, the spine surgeon wants his or her patient to have a successful outcome after surgery too. MIS surgery may help shorten a patient’s length of stay in the hospital, reduce blood loss during surgery, reduce the risk for infection, help lessen muscle and tissue injury, reduce postoperative pain and the need for pain medications, smaller scar, faster healing, and return to normal activities sooner.