Minimally Invasive Spine Surgery Smaller incisions, More Benefit

‘Traditional vs Minimal Invasive Spine Surgery’

Conventional spine Surgery is the Gold Standard for any spine procedure. However, there is always a collateral damage/ injury to the muscles / surrounding structures. Minimally invasive Spine Surgery (MISS) is a surgical technique that aims to limit this collateral damage using smaller incisions and minimal muscle dissection to achieve same desired surgical outcome.

How is it performed?

Minimal invasive surgery is usually performed after making a paraspinal incision and inserting a port/ tube though these incisions to relieve the neural structures of compression. The important components of Minimal Invasive spine surgery are access (port), illumination (light source) and magnification. It can be achieved by using

Tubes (Fixed or Expandable) and the light source can be headlight and surgical eye loops provide magnification. Alternatively, microscope can replace both and is much more versatile.

Endoscope – which may be UBE (Unilateral Biportal Endocopy or Percutaneous single channel ) Endoscopy.

The safety and precision of minimal Invasive Spine Surgery can be further enchanced using Neuro-navigation, Intra-Operative Neuro Monitoring (IONM) and Robotic Assisted Spine Surgery.

What are the benefits?

This approach offers several advantages over traditional or conventional open/ traditional spine surgery, including:

  • Less blood loss.
  • Reduced muscle damage/ dissection.
  • Shorter hospital stay.
  • Faster recovery times.
  • Less scarring.
  • Lower risk of infection.

This results in significant benefits to patient. The post operative pain is less; therefore patient can be mobilized early. Less blood loss means quicker recovery and reduced blood transfusion requirements.

The conditions that can be treated with MISS:

  • Herniated/ Slipped discs.
  • Lumbar Spinal stenosis.
  • Spondylolisthesis
  • Stabilization of Fractures
  • Tumors
  • Scoliosis

How is MISS performed?

Minimal Invasive Spine Surgery is usually performed using smaller paraspinal incisions as compared to midline longer incision in conventional surgery. This is mostly performed under general anesthesia.

What is the recovery time for MISS?

It usually varies with type of procedure, no of levels operated and patient’s pre existing health status. The recovery time for MISS is usually much shorter than that of traditional open spine surgery. Most patients can go home the next day. In certain cases, it can be done as a day care procedure also. Pain and discomfort in the post op period is much less.

Can all conditions be treated with MISS?

Not all conditions/ diseases of spine can be treated with MISS. There are certain pathologies which are best approached by conventional techniques. However, the scope of minimal invasive spine surgery is constantly expanding and with invent of better equipment and instruments, more and more pathologies become amenable to MISS.

Keywords:

Minimally invasive spine surgery (MISS); back pain; Herniated discs; Degenerative disc disease; Spinal stenosis; Spondylolisthesis; Scoliosis; Fractures; Tumors; Apollo Hospitals, Navi Mumbai