Spine surgeries were traditionally done only as open surgeries, implying that the surgeon will make a long incision to view and access the anatomy. The surgery is complicated and often involves a lot of risks and a longer recovery period. Hence, with recent medical advancements, newer, minimally invasive techniques have been discovered to treat spine problems and injuries.
A minimally invasive spine surgery (MISS) is a type of surgery on the spinal bones (backbones). As opposed to traditional spine surgery, a minimally invasive method uses smaller incisions to treat the problem. This approach causes less harm to surrounding muscles and tissues and is often less painful and comparatively faster than open spine surgery. Overall, minimally invasive surgery is faster, safer and requires less recovery time.
In general, the objective of minimally invasive spine surgery is to stabilize the vertebral bones and spinal joints or to relieve the pressure from the spinal nerves, which is a cause of spinal instability, bone spurs, herniated discs, spinal tumours and other spine-related problems.
Benefits of a Minimally Invasive Spine Surgery
- Less blood loss from surgery
- Faster recovery
- Smaller, less painful incisions
- Shorter and faster procedures
- Higher success rates
- Low chances of infection
- Minimal or no damage to surrounding tissues and muscles
- Reduced postoperative pain
- No dependence on medications after surgery
- Less rehabilitation
- Better cosmetic results
Also, in many cases, the procedure uses only local anaesthesia, which further lowers the risks from the surgery such as adverse or allergic reactions to anaesthesia.
Common Conditions Treated Via Minimally Invasive Spine Surgery
Some of the conditions which can effectively be treated with this type of surgery include:
- Degenerative spine disc disease
- Herniated disc
- Spinal deformities
- Spinal infections
- Spinal tumours
- Spinal instability
- Vertebral compression fractures
- Lumbar spinal stenosis
Common Minimally Invasive Spinal Surgeries
Diskectomy: Diskectomy is a minimally invasive spinal procedure to relieve the pain, numbness or weakness in the leg caused due to a pressurized nerve resulting from a herniated disc in the lower back. In this surgery, the surgeon makes a small incision over the herniated disc location and then inserts a retractor to remove a small part of the lamina bone, to gain fair access to the spinal nerve and disk. Once through, the surgeon retracts the affected nerve and removes the damaged disc.
Spinal Decompression: Narrowing of the vertebral canal can cause compression of the spinal nerves, which can produce multiple symptoms such as intense pain, weakness or numbness. In spinal decompression surgery, the doctor removes the bone and soft tissue which is causing the nerve compression. The procedure will be conducted through tubular dilators, a microscope or an endoscope.
Transforaminal Lumbar Interbody Fusion (TLIF): This type of MISS procedure is most effective for conditions such as spondylolisthesis, degenerative disc disease and recurrent disc herniation. In this, the surgeon makes two small incisions and places screws and rods between the two or more affected vertebral levels. The intervertebral disc is removed and a cage is placed to stabilize the vertebral levels.
The procedure of a Minimally Invasive Surgery
Though, the actual procedure depends on the type of MISS surgery, the part being treated and several other factors. Yet, the typical procedure of a MISS surgery, most of which use tubular retractors, is as below:
The patient will be administered with the required type of anaesthesia (local or general) or sedation before the surgery. Once done, vital health signs of the patient such as blood pressure, heart rate, pulse, will be carefully assessed. Then a surgeon will make small incisions on the back in the particular area which needs to be treated; post this, a tubular retractor is placed in the incision to expose the part of the spine that needs treatment.
The surgeon will then pass small tools through the retractor, including a tiny camera and light, which will function to repair the damage caused to the spine. The tools will be guided through special X-ray machines. Once the repairs are done, the tools and retractors are removed from the spine, incisions are closed and bandaged.
Recovery after a Minimally Invasive Surgery
In most cases, the procedures are shorter and have a faster recovery, allowing patients to go home the same day of the surgery. In other cases, the healthcare provider might require the patient to stay for a night for observation.
The patient would need to be accompanied by a family or friend since he/she cannot drive post the procedure. There may be some pain and general discomfort after the surgery, which is expected to wear off on its own or through recommended pain medicines. The patient can experience certain leakage from the incision site, which is normal. In case, the leakage increases or tends to cause a fever or worsening pain, the healthcare provider must be informed.
The recovery steps and guidance on precautions related to the usage of the back will be explained by the doctor. Generally, lifting and bending will need to limit or completely avoided for some time. Some patients might require back brace for a certain period to ensure ulterior support. Also, physical therapy is generally recommended to post a MISS procedure to allow the muscles to recover and regain strength.
Risks of a Minimally Invasive Spine Surgery
Even though a minimally invasive spinal surgery is comparatively less risky than open surgery, still there are some risks associated with this method of treatment. These include:
- Excess bleeding
- Pain at the site of incision
- Nerve damage
- Blood clotting
- Complications from anaesthesia
- Leakage of spinal fluid causing headache or more problems
- No relief in back pain
Also, the patient may be more prone to risks depending on the age, general health condition and the type of minimally invasive procedure.