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Minimally Invasive Spine Surgery

Surgeon in operating room standing over patient with a fluoroscope and performing minimally invasive spine surgery

In the past, the primary method of all spine surgeries was to make a long incision through the affected area which would allow the surgeon enough access to perform the procedure. Nowadays, however, that method is quickly becoming outdated as new surgical advances emerge, making spine surgery much less invasive than it has been in the past. More and more orthopedic surgeons are now opting to perform minimally invasive spine surgery on their patients due to the many benefits of this new approach.

Minimally invasive spine surgery, or (MISS), uses special tools to access the spine through small incisions. In traditional spine surgery, commonly referred to as open surgery, the surgeon uses a longer incision and then pulls the muscles to the side, exposing the spinal cord. This pulling of the muscles can lead to damage of the muscles and surrounding soft tissues. Unlike open surgery, MISS allows surgeons to access the spine without having to retract the surrounding muscles.

MISS can be done using a variety of techniques, all of which use smaller incisions and result in less muscle damage. One of the most prevalently used techniques utilizes a tubular retractor as a tunnel leading the the exact problem area of the spine. Through the use of the tubular retractor and a fluoroscope, which projects real-time x-ray images of the patient’s spine onto a screen, the surgeon is able to perform the surgery. The tiny retractor will continue to hold the muscles open while the surgeon operates within the tunnel to correct the issue. Because everything is placed or removed via this tunnel, sometimes more than one retractor may be used in an operation. However, even the use of multiple retractors results in far less muscle damage than an open surgery since the muscles instantly return to their normal positions as soon as the retractors are removed.

Two of the most common procedures that are done utilizing MISS are Lumbar Discectomy and Lumbar Fusion. Lumbar Discectomies are used when a herniated disc is pinching a nerve. In this procedure, the surgeon inserts the tubular retractor, retracts the nerve, and removes the damaged disc. This procedure can also be done for cervical vertebrae and is called Posterior Cervical Discectomy. Lumbar Fusion can be performed for a variety of reasons and is performed by placing a retractor on either side of the spine, removing the lamina and disc, inserting a bone graft into the space left by the disc, and fastening screws or rods to add support.

The recovery time for patients who have undergone MISS is much less than for those who have undergone open spinal surgery. For starters, MISS patients have shorter hospital stays, although this does depend on the procedure and the individual. Hospital stays can range anywhere from going home the same day as the procedure to staying for 1-2 days. In addition, MISS patients experience a much lower rate of postoperative pain since the muscles did not undergo extensive retraction during the procedure. Depending on your procedure, your doctor may also recommend physical therapy or new methods of moving properly, repositioning, sitting, standing, and walking.

Minimally invasive spine surgery provides patients with a much easier alternative to traditional open surgery. In doing so, MISS has allowed more people to get the relief they need. Have more questions about MISS? Contact your doctor today!

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