Minimally invasive spine surgery (MISS) is sometimes called less invasive spine surgery. In these procedures, doctors use specialised instruments to access your spine through small incisions rather than traditional open surgery that requires large incisions.
The field of minimally invasive spine surgery continues to grow. Most spinal conditions today can be treated with some aspect of minimally invasive surgery.
The goal of minimally invasive spine surgery is to stabilise your vertebral bones and spinal joints and/or relieve pressure on your spinal nerves. These are often caused by conditions such as herniated discs, spinal instability, bone spurs, scoliosis or spinal tumours.
Benefits of MISS
Minimally invasive spinal surgery offers a number of benefits when compared to open spine surgery. These include:
-Most often faster and safer option
-Less blood loss from surgery
-Less muscle and soft tissue trauma
-Reduced risk of nerve and muscle damage
-Less recovery time and rehabilitation required
-Decreased hospital stays, typically by 50%. (For endoscopic discectomy patients often go home the same day of the operation, and for those having lumbar fusion surgery, home time typically is within two to three days as opposed to a hospital stay of five to seven days for open surgery.)
-Less scarring as smaller incisions (sometimes as small as two centimetres)
-Reduced risk of infection
-Much less postoperative pain and lower reliance on pain medications after surgery
-Some procedures can be performed on an outpatient basis using a local anaesthetic rather than using a general anaesthetic.
Conditions treated using MISS
Many spinal conditions can now be treated using minimal invasive surgery. They include:
-Degenerative disc disease
-Herniated disc
-Lumbar spinal stenosis
-Spinal deformities such as scoliosis
-Spinal instability
-Spinal infections
-Vertebral compression fractures
-Spinal tumours
Common MISS treatments
Some of the most common MISS treatment options include:
Discetomy
You have spinal discs in your spine that act as cushions between your vertebral bones. These discs can become weakened and may rupture or herniate and this herniated disc material can compress on passing nerves and cause severe pain.
Disectomy is a MISS to trim or remove the herniated disc using tubular dilators and an endoscope.
Spinal decompression
Spinal stenosis is a common condition where your vertebral column becomes narrowed and your nerve becomes compressed, causing pain, numbness and muscle weakness.
During spinal decompression surgery your surgeon will create more space for your nerve by removing bone and soft tissue in your vertebral column that are compressing it. They will perform this procedure using tubular dilators and an endoscope. The more common decompressive procedures include laminectomy (removal of bone) and foraminotomy (removal of bone and tissue).
MIS lumbar fusion
A common MIS lumbar fusion is the transforaminal lumbar interbody fusion (TLIF). Using this technique, your surgeon approaches your spine slightly from the side to reduce the amount of spinal nerve movement. This surgery uses tubular retractors that expand once in place and allows the lamina and the disc to be removed, bone graft to be placed into the disk space, and screws or rods to be placed to provide additional support.
This MISS is performed on patients with low back pain associated with spondylolisthesis, degenerative disc disease and recurrent disc herniation. It may also be used for patients with post-laminectomy instability, spinal trauma or pseudoarthrosis.