Minimally invasive spine surgery is an endoscopic procedure that uses specialized video cameras and instruments that are passed through small incisions (less than 2 cm) in the back, chest or abdomen to access the spine and perform the needed surgery.
Endoscopic techniques have been used for several decades, but for diagnostic purposes only. In the late 1970s and early 1980s, endoscopic techniques were advanced so that both a diagnosis could be made and the disease could be treated. These same endoscopic techniques used in other surgical disciplines have now been advanced to the treatment of spine disorders.
Not every patient, however, is a candidate for a minimally invasive approach to spine surgery. To see if you are a candidate for this approach for spinal tumors, deformity, trauma, or degenerative disease you must be fully evaluated by a surgeon knowledgeable and experienced in these minimally invasive techniques.
In certain cases of degenerative discs, scoliosis, kyphosis, spinal column tumors, infection, fractures and herniated discs, minimally invasive techniques may speed recovery, minimize post-operative pain and improve the final outcome. Many types of minimally invasive spine surgery are:
Minimally invasive spine surgery offers several advantages over open surgery, which typically requires large incisions, muscle stripping, more anesthesia, a long hospital stay, and a long recuperation period. The benefits of spine surgery include:
As with any surgical procedure, including minimally invasive spine surgery, there are general risks and procedure-specific risks. The more common general risks of spine surgery include the risk of adverse reactions to the anesthetic, post-operative pneumonia, blood clots in the legs (deep vein thrombosis) that may travel to the lungs (pulmonary embolus), infection at the site of surgery and blood loss during surgery requiring a transfusion. The specific risks of spine surgery include the risk of injury to the nerves or spinal cord resulting in pain or even paralysis, (the estimated risk of paralysis for major spinal reconstructions is somewhere around 1 in 10,000), the instrumentation, if used, breaking, dislodging or irritating the surrounding tissues, and pain from the surgery itself. On rare occasions, during a minimally invasive procedure, the planned surgery cannot be completed and requires either a second trip to the operating room or a conversion from the minimally invasive technique to a full open technique.
To prepare for spine surgery, quit smoking if you smoke, exercise on a regular basis to improve your recovery rate, stop taking any non-essential medications and any herbal remedies which may react with anesthetics or other medications and ask your surgeon all the questions you may have.
Most types of minimally invasive surgery rely on a thin telescope-like instrument, called an endoscope, or on a portable X-ray machine, called a fluoroscope, to guide the surgeon while he or she is working. The endoscope is inserted through small incisions in the body. The endoscope is attached to a tiny video camera – smaller than a dime – which projects an internal view of the patient’s body onto television screens in the operating room. Small surgical instruments are passed through one or more half-inch incisions, which are later closed with sutures and covered with surgical tape. The fluoroscope is positioned around the patient to give the surgeon the best X-ray views from which to see the anatomy of the spine.
As modern medical care grows more complex, patients can feel overwhelmed. The opportunity to consult a recognized authority about a particular diagnosis and treatment can bring peace of mind at an emotionally difficult time. A second opinion may be beneficial when: