Minimally invasive spine surgery
Spine surgery is traditionally done as “open surgery,” meaning the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.
Because minimally invasive spine surgery (MISS), does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.
As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. Because of the reduced trauma to the muscles and soft tissues (compared to open procedures), the potential benefits are :
- Better cosmetic results from smaller skin incisions (sometimes as small as 2 centimeters)
- Less blood loss from surgery
- Reduced risk of muscle damage since less or no cutting of the muscle is required
- Reduced risk of infection and postoperative pain
- Faster recovery from surgery and less rehabilitation required
- Diminished reliance on pain medications after surgery
In addition, some MIS surgeries are performed as outpatient procedures and utilize only local anesthesia — so there is less risk for an adverse reaction to general anesthesia.
As with any surgical procedure, no matter how minimal, there are certain risks associated that include but are not limited to:
- Possible adverse reaction to the anesthetic
- Unexpected blood loss during the procedure
- Localized infections, no matter how small the incision area
Conditions Treated Using MIS Procedures
- Degenerative disc disease
- Herniated disc
- Lumbar spinal stenosis
- Spinal deformities such as scoliosis
- Spinal infections
- Spinal instability
- Vertebral compression fractures
- Spinal Tumors
Surgery should always be the last resort when it comes to treating spinal conditions in the neck and back. However, if various non-operative treatments have been attempted without improvement or worsening over a 6-12 month period, then surgical treatment seems reasonable for certain specific conditions such as spinal stenosis, sciatica, spondylolisthesis or degenerative scoliosis. The decision for surgery should be individualized to the patient and the patient’s symptoms, along with their level of function
The field of minimally invasive spine surgery continues to grow. Most surgeries today can be treated with some aspect of minimally invasive surgery. However, there are certain conditions that require standard open treatment, such as high-degree scoliosis, tumors and some infections.
The best options should be individualized to the patient’s diagnosis and overall patient condition. At UCSD we perform both minimally invasive spine surgery, as well as open-surgery, and choose the type of treatment that is best suited for the individual patient
The integration of our newest technolgies that assist in MISS surgery often require that radiologic procedures be tailored to fit each operation and will often require a new scan.
In general, minimally invasive spine surgery decreases the hospital stay by one-half. In a typical endoscopic discectomy, the surgeries are performed in the same day, and the patients go home shortly after surgery on the same day.
For various types of lumbar fusion surgery, the patient typically goes home in 2-3 days, where previously they stayed in the hospital 5-7 days. Furthermore, the immediate post-operative period is marked by much less pain when using minimally invasive techniques.
he decision to return to work should be individualized to the patient, as well as the patient’s occupation. For patients with sedentary jobs, such as office work, a minimally invasive discectomy would allow that patient to begin part-time work within 1-2 weeks. For a larger surgery such as a fusion, this may take 4-6 weeks. Again, return to work is much faster using minimally invasive surgery vs. standard open surgery but this decision is individualized to special needs of each patient.
Recovery from each surgery is different. Some patients return to full activity in 6 weeks while other patients require more time. We encourage all patients to participate in a physical therapy program to safely begin the process of returning to all normal activities.
On average, patients who have had minimally invasive spine surgery are discharged in half the time of traditional surgery and the pain usually follows this rule. Each procedure will have a differnent rate of recovery.