As technology improves, the ability of spine surgeons to treat certain conditions of the spine with smaller incisions that are less traumatic to the patient is now possible. These Minimally Invasive Surgery (MIS) or “minimal access” techniques have many potential benefits, including:
- Small incisions
- Lower blood loss from surgery
- Less damage to spinal muscles and soft tissues
- Less risk of infection
- Less post-operative pain
- A shorter hospital stay
- Scars that are smaller and less apparent
- Faster recovery
Many spinal disorders can be addressed with Minimally Invasive Surgery techniques, including spinal deformity, degenerative disc and spine disease, tumors, infection and trauma. To perform surgery on the spine, the surgeon can use anterior, posterior, lateral or combined approaches (anterior and posterior or lateral and posterior). With the advent of MIS techniques, these approaches have been modified and improved. Anterior approaches, for example, disturb the spine itself less because they involve less dissection to approach the spine. In addition, the important posterior muscles of the spine are not disrupted, and spinal nerves are not moved during surgery. With improvements to instrumentation used in spinal surgery, video technology and retraction systems, anterior spine surgery has been also improved with the use of “mini-open” surgical approaches and laparoscopic techniques. Because of this, combining MIS anterior approaches with MIS posterior instrumentation allows the anterior pathology to be addressed directly, while maximal spinal stability is added without disrupting posterior spinal muscles significantly. For certain diagnoses and indications, MIS posterior approaches can be used to treat anterior and posterior spinal disease, and to stabilize the spine, through multiple small incisions, by using specialized retractor systems, intra-operative fluoroscopy, and computer navigation assisted surgery. Computer navigation-assisted surgery allows surgeons to more accurately place screws into bone in the spine, through small incisions and in some cases, where surgery was previously impossible because of danger to nerves and blood vessels.
Not all spinal conditions can or should be addressed with MIS techniques, but with for patients with the proper indications, they can be very beneficial. Combined with intra-operative, computer navigation-assisted surgery, and the use of biological bone growth enhancers, MIS surgery may improve the safety, outcomes and efficacy of spinal surgery.
The pictures on the right show the pre-op x-rays, post-op x-rays, and the small incisions of a patient with spondylisthesis, treated with Minimally Invasive Surgery techniques. This patient was able to leave the hospital two days after surgery and is doing very well.