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A Comprehensive Guide to Types of Minimally Invasive Spine Surgery

Image of a doctor showing x-ray of spine to senior man at hospital illustrates the Minimally Invasive Spine Surgery types for spine surgery.
Published Dr. Umesh Srikantha on February 29, 2024

Does your spine require surgery to strengthen or rectify it? Say goodbye to painful major surgical options. Minimally invasive spine surgery options are better to fix various issues. Why?

There’s lesser post-surgical pain and quicker recovery.

Surgeries like discectomy and spinal fusion, along with new treatments like disc arthroplasty, aim to better your life. Being familiar with these options empowers you to have an informed conversation with your doctor before moving forward with your surgery.

Understanding Minimally Invasive Spine Surgeries

Minimally Invasive Spine Surgery (MISS) is a big step in bone surgery. It's a less harsh option than open surgery. MISS aims to fix bones, ease nerve stress, and treat spine problems with less body impact.

It also aims to shorten hospital stays. MISS also means less blood loss, more minor scars, and fewer risks of infection and trouble. Knowing MISS types and their benefits is key because they offer custom fixes for your spine health.

Diving into Minimally Invasive Spine Surgery Methods

MISS has many methods for different issues. Here's a brief look at some:

  • Spinal fusion rectifies curved spines and broken bones, providing more spinal stability.
  • Vertebroplasty and kyphoplasty treat spinal fractures. Kyphoplasty uses a balloon to make room for bone cement, which might bring back some bone height.
  • Newer methods like disc arthroplasty and nerve stimulators offer ways to manage lasting back pain and pain relief.

These methods show how MISS has grown, giving custom ways to fix your spine and lessen pain.

1. Discectomy: Procedure and Applications

A discectomy removes damaged disc parts causing pain due to spinal nerve compression. If you have bad back pain, numbness, or weakness, a discectomy might be the fix you need.

During this procedure, your surgeon makes a small incision and uses special tools to remove the damaged disc. This method causes less tissue harm and helps you heal faster than open surgery.

2. Spinal Fusion: Techniques and Variants

MISS, like spinal fusion, uses tiny incisions and special tools to place bone grafts or implants to speed up healing. You can choose from self-donated grafts, donated grafts, or artificial materials like Bone Morphogenetic Proteins and ceramics. Surgical access can be from the front, side, or back, depending on your issue. Tools like rods and screws help keep bones in place while they fuse.

3. Vertebroplasty vs. Kyphoplasty: Comparative Procedures

For spinal fractures, less invasive choices like Vertebroplasty and kyphoplasty offer relief and support. Both surgeries have different procedures but aim towards easing pain and strengthening bones.

Vertebroplasty puts bone cement right into the broken bone for fast pain relief and stability. Kyphoplasty adds a step where a balloon makes space in the bone for the glue. This not only makes the bone stable but also tries to regain the bone height lost from the fracture.

4. Innovative MISS Techniques: Arthroplasty and Stimulators

For persistent low back pain from worn-out discs, disc arthroplasty might be an option. This MISS replaces a painful disc with a device that moves like a real disc. Arthroplasty helps when other treatments fail to deliver results after six months and if the pain affects your routine life.

Another new MISS is nerve stimulator implantation for chronic pain. It places a device that sends small electric pulses to the spine nerves. The stimulator has thin wires and a small battery. Your doctor inserts the wires near the spine and the battery near your belly or hips. The electric pulses block the brain's pain signals, masking the pain. This procedure facilitates pain management, especially after surgery.

While these new methods are exciting, always consider all the MISS options, including their benefits and drawbacks.

Pros and Cons of Minimally Invasive Spine Surgery

Let's look at the good and the not-so-good of MISS:

Clinical Benefits of MISS:

  • Decreased blood loss during surgery
  • Reduced postoperative pain
  • Reduced need for pain medication (analgesic) after surgery
  • Shorter hospital stays
  • Quicker return to work and daily activities
  • Decreased risk of postoperative wound infections (both superficial and deep)
  • Enhanced clinical outcomes based on Oswestry Disability Index scores
    Smaller, cosmetically appealing incisions

Biomechanical Benefits of MISS:

  • Preserved muscle attachments: Serial dilation creates a tract that protects muscle attachments.
  • Reduced retraction-induced damage: Lower pressure within adjacent muscles minimises damage.
  • Intact post-operative segmental motion: Prevents segmental hyperflexibility often seen with conventional surgeries.
  • Improved post-operative extensor muscle function: Maintains better muscle area and strength.
  • Reduced post-operative inflammatory response: Significant decreases in inflammatory markers compared to open procedures.
  • Improved short-term and long-term radiological parameters: Lesser immediate muscle signal changes and enhanced long-term muscle area observed post-MISS.

While minimally invasive spine surgery (MISS) presents significant benefits over traditional open surgery, it's important to be aware of some potential downsides:

  • Learning curve: The learning curve is steep because of the reduced visibility and anatomical disorientation.
  • Patient selection: Some cases may not be suitable for MISS. The surgeon will decide based on their expertise and the infrastructure available at their disposal.

Open surgery might be the best option for complex cases or big rebuilds. Severe spine shapes or tumours might need a more open method for the best view and access.

Your spine expert will help weigh these points to find the best surgery for your case. With many MISS types, talk with a spine specialist to find the right one for your issue.

Also Read : Essential Ways to Avoid Back Pain for a Stronger Spine

Assessing Candidacy for Spine Surgery and Consultation

Factors considered while assessing candidacy for MISS:

  • Case Selection: Assessing appropriateness for MISS based on the nature and severity of specific spinal conditions.
  • Surgeon’s Experience: Ensuring surgeons possess proficiency in the intricacies of MISS techniques.
  • Complexity: Determining the feasibility of MISS procedures based on anatomical and pathological factors.
  • Infrastructure: Considering the availability of advanced surgical technology and facilities within the hospital setting.
  • Support Staff: Recognising the indispensable role of a skilled and trained team in the successful execution of MISS procedures.

Also, a number of factors contribute to the preference for Minimally Invasive Spine Surgery (MISS) over traditional open surgery:

  • Advanced Age and Health Conditions:

MISS is often favoured due to its smaller incisions and quicker recovery compared to open surgery, which is particularly beneficial for individuals with advanced age or poor health.

  • Obesity Considerations:

MISS presents several advantages for obese patients, including consistent incision sizes regardless of body size, unlike in open surgery, where incision sizes tend to be larger in obese individuals compared to slim ones.

  • Reduced Risk of Complications:

MISS typically entails lower risks of fat necrosis and wound infections compared to open surgery, making it a safer option for patients.

  • Potential for Revision Surgery:

MISS techniques also offer the possibility of performing revision surgeries when necessary, further highlighting its versatility and applicability in various scenarios.

Talk with your spine experts for more details to make a smart choice. They will go over the different MISS and how they might help you. Ask questions and share your worries to make an informed decision.

Knowing the MISS types and their uses helps you talk with your spine expert. Remember that a custom treatment plan that looks at all your health parts is very important.

MISS- A Step Towards Renewed Spinal Health

Your search for better spine health should offer options that cut pain and expedite healing. MISS types help many spine issues, improving outcomes and promoting faster recovery. Choosing MISS means less impact on your body and a better healing path.

Consult the best spine specialists who can lead you to the right choice. Spine 360 gives you a team focused on top MISS for care made just for you. Look for relief – learn more about our spine care services.

FAQs

How long does it typically take to recover from minimally invasive spine surgery?

Recovery varies depending on the type of surgery but can be summarised as follows:

MISS Discectomy or Decompression:

  • Hospital Stay: 1-2 days
  • Walking and ADL (Activities of daily living): 1-2 days
  • Return to simple work: 8-10 days
  • Return to physical exertion/ sports: 6-8 weeks

MISS Fusion:

  • Hospital stay: 2-4 days
  • Walking and ADL: 2-4 days
  • Return to simple work: 2-3 weeks
  • Return to physical exertion / sports: 3-6 months

Recovery also depends on:

  • Level of activity prior to the development of the disease
  • Duration of illness (shorter duration means faster recovery)
  • Age and general health condition.

What should I expect during recovery from minimally invasive spine surgery?

Recovery from minimally invasive spine surgery typically involves:

  • Shorter hospital stay, possibly same-day discharge.
  • Minimal rest period before resuming normal diet.
  • Mild postoperative pain managed with prescribed or OTC medication.
  • Incision site care to avoid infection.
  • Gradual return to routine activities over time.
  • Physical therapy to strengthen back muscles.
  • Total recovery can vary, averaging around 6 weeks.
  • Regular postoperative checkups and adherence to surgeon's advice.

What conditions can be treated with minimally invasive spine surgery?

  • Spinal instability
  • Bone spurs
  • Herniated discs
  • Lumbar spinal stenosis
  • Spinal deformities, e.g., scoliosis
  • Spinal infections
  • Vertebral compression fractures
  • Spinal tumours

What technological advances are there in minimally invasive spine surgery techniques?

  • Navigation Systems: Improves accuracy and safety, especially in pedicle screw fixation, through real-time guidance.
  • Intraop 3D Imaging: Offers surgeons the ability to view the spine from multiple angles during surgery, ensuring accurate placement of hardware and minimising the need for revisions.
  • Intraop Neuromonitoring: Continuously monitors the patient's neural function during surgery to prevent nerve damage, improving patient outcomes and safety.
  • Spine Robot: Employs robotic assistance to increase the accuracy of screw placement and reduce exposure to radiation, leading to higher precision in complex procedures.

These surgical tools and devices are specifically designed to enhance the safety and effectiveness of spine surgeries.

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Dr. Umesh Srikantha

M.Ch (Neurosurgery)
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