Minimally Invasive Spine Surgery

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What is minimally invasive spine surgery?

Minimally invasive spine surgery (MISS) is a type of surgery on the bones of your spine (backbone). This type of surgery uses smaller incisions than standard surgery. This often causes less harm to nearby muscles and other tissues. It can lead to less pain and faster recovery after surgery.

The standard method of spine surgery is called open surgery. This uses a long incision down the back. The muscles and soft tissue around the spine would need to be moved away. In some cases, tissue would need to be removed.

During MISS, the healthcare provider makes a smaller incision. He or she then inserts a device called a tubular retractor. This is a stiff, tube-shaped tool. It creates a tunnel to the problem area of the spine. It gently pushes aside the muscle and soft tissue around the area. The surgeon can then put small tools through the tunnel to work on the spine. The surgeon also uses a special operating microscope and views real-time X-ray images of the spine.

Surgeons can use MISS for some types of spine surgery. These include lumbar discectomy, laminectomy, and spinal fusion.

Why might I need minimally invasive spine surgery?

Most people who have back pain will not need surgery. Your healthcare provider might advise spine surgery if you have a back problem that hasn’t gotten better with another treatment, such as medicine or physical therapy. If you still have a lot of pain, surgery on your spine might fix the problem. Spine surgery can’t fix all types of back problems, though. Your healthcare provider will only advise spine surgery if you have a type of problem that surgery may help.

This includes conditions such as:

    • Herniated disc
    • Spinal stenosis (narrowing of the spinal canal)
    • Spinal deformities (like scoliosis)
    • Spinal instability
    • Spondylolysis (a defect in part of a lower vertebrae)
    • Fractured vertebra
    • Removal of a tumor in the spine
    • Infection in the spine

If you are thinking about spine surgery, ask your healthcare provider if MISS is a choice for you. Not all types of spine surgery can be done with MISS. And not all hospitals or other surgery facilities are equipped for MISS.

What are the risks of minimally invasive spine surgery?

Every surgery has risks. The risks of minimally invasive spine surgery include:

    • Infection
    • Excess bleeding
    • Pain at the graft site
    • Nerve damage
    • Blood clots
    • Complications from anesthesia
    • Leaking of spinal fluid. This may cause headaches or other problems.
    • Not enough relief of your back pain

     

Your own risks may vary according to your age, your general health, and the type of surgery you have. Having the surgery at a facility that is experienced in the method can help lower your risks.

How do I prepare for minimally invasive spine surgery?

This includes over-the-counter medicines such as aspirin. You may need to stop taking some medicines ahead of time, such as blood thinners. If you smoke, you’ll need to stop before your surgery. Smoking can delay healing. Talk with your healthcare provider if you need help to stop smoking.

Before your surgery, you may need imaging tests. These may include X-rays or magnetic resonance imaging (MRI).

Do not eat or drink after midnight the night before your surgery. Tell your healthcare provider about any recent changes in your health, such as a fever.

What happens during minimally invasive spine surgery?

MISS is done by an orthopedic/neurosurgeon and a trained medical team. The details of MISS vary depending on what part of the spine is being treated, and other factors. Your healthcare provider can help explain what to expect for your surgery. The following is an example of how MISS is done:

    • You may have a type of anesthesia that numbs part of your body. You’ll also be given sedation. This will make you relaxed but awake during surgery. Or you may be given general anesthesia. This prevents pain and causes you to sleep through the surgery.
    • A healthcare provider will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.
    • You may be given antibiotics before and after the surgery. This is to help prevent infection.
    • During the procedure, your surgeon will use a special type of X-ray to view the surgery.
    • The healthcare provider will make a small incision on your back in the area that needs to be treated. A tubular retractor is put into this incision. This will expose the part of the spine to be treated.
    • The surgeon will then pass put small tools through this retractor. This includes a tiny camera and a light.
    • Your healthcare provider will then make the needed repairs to the spine.
    • When the repairs are done, the tools and retractor are then removed. The incision or incisions are closed with stitches, glue, or staples. A small bandage is put on the wound.

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