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What Conditions can be treated by Minimally Invasive Spine Surgery

A collage of the clinical illustrations of minimally invasive spine surgeries.
Published by Dr. Umesh Srikantha on April 12, 2020

Ever since its introduction to treat lumbar disc herniations by Kevin Foley in 199812,13, MISS has been adapted widely to treat almost all disorders of the thoracolumbar spine and many disorders of the cervical spine. With ongoing developments in instruments and technology, it is only prudent to say that time will continue to inculcate newer and advanced indications to treat an even wider variety of spinal disorders with minimally invasive techniques.

The following conditions are being treated with minimally invasive techniques at the author’s center. Nearly 90% of surgeries done by Dr. Umesh Srikantha and his team are minimally invasive in nature.

Table. List of basic and advanced indications for MISS

Thoraco-lumbar

Routine

Advanced

Tube assisted Microlumbar discectomy

Posterolateral Thoracolumbar corpectomy, interbody fusion

MIS decompression for LCS

Lateral Lumbar interbody fusion (DLIF/ OLIF) – Single and Multiple level; including degenerative deformity correction

MIS – TLIF (single and Multi-level)

Lateral Lumbar corpectomy, interbody fusion

Percutaneous pedicle stabilization for Koch’s spine/ Traumatic spine injury

MIS – iliac screw and Lumbo-pelvic stabilizaiton

Percutaneous Endoscopic Lumbar Discectomy (PELD)

Cervical

Posterior cervical laminoforaminotomy and discectomy

Atlanto-axial fusion (C1 lateral mass-C2 pedicle)

Subaxial cervical screws – Lateral mass and Pedicle screws

Multi-level decompression for degenerative cervical myelopathy

Others

Spinal tumours – IDEM, Extradural, Paraspinal; entire spinal axis

Adult filum detethering

Syringo-subarachnoid shunt

Transforaminal biopsy (endoscopic/ image guided)

LCS – Lumbar canal Stenosis; DLIF – Direct Lateral lumbar interbody fusion; OLIF – Oblique lateral lumbar Interbody fusion; TLIF – Transforaminal Lumbar Interbody Fusion; PELD –Percutaneous Endoscopic Lumbar Discectomy; IDEM – Intradural, Extramedullary

Please visit ‘services’ page for further details about these procedures

Figure description: Clinical Illustrations of Tubular retractor assisted surgeries

A: Serial dilators in place after placement of a 18mm fixed tubular retractor

B: Tubular working channel after removing serial dilators, positioned for microscope assisted discectomy

C: Intra-operative C-arm confirming placement of a fixed tubular retractor for surgery at the CVJ, in this instance removal of C2 Neurofibroma

D: Single level MIS-TLIF being performed with a semi-expandable tubular retractor, using regular non-cannulated screws

E: Intra-operative C-arm confirming placement of a fixed tubular retractor for correction of L5-S1 spondylolisthesis

F: Expandable tubular retractor positioned for thoracic decompression

G: Intra-operative C-arm image showing placement of cervical pedicle screws through an expandable tubular retractor

H: Intra-operative clinical photograph showing tube positioned on one side with percutaneous cannulated pedicle screws on the other side for reduction of Spondylolisthesis

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