Overview
Minimally Invasive Spine Surgery
Minimally invasive spine surgery can be used to remove a herniated disc in the back. Techniques also allow fusion, including the placement of spinal instrumentation, when required. Spinal stenosis can also often be treated by this technique.
These types of surgery involve placement of a tubular retractor to gain access to the spine. This allows the back muscles to be split, instead of being cut. The result is less muscle injury and a shorter recovery. Surgery is often performed with a microscope to maximize safety and precision. Spinal compression fractures, for example from osteoporosis in elderly patients, can also be treated with minimally invasive techniques. This can be performed via kyphoplasty.
Minimally invasive surgery is used to treat disorders of the cervical, thoracic and lumbar spine, including herniated discs without making a large incision in the skin or cutting the muscles that cover the spine. There are many types of procedures used to treat a wide range of spinal disorders.
Benefits of minimally invasive surgery
Minimally invasive surgery is quickly becoming the method of choice for combating neurological disorders that demand surgical treatment. Typically resulting in less pain, scarring and recovery time than traditional surgery, minimally invasive procedures also generally incur lower heath-care costs.
Also known as minimal access spine surgery and endoscopic surgery, minimally invasive spine surgeries are designed to produce the same results as traditional operations, but are made with smaller incisions and minimal cutting of muscle. Specially designed instruments called tubular retractors pair with endoscopes, or small cameras, are inserted through fingernail-sized incisions allowing surgeons the ability to see the spine with minimal cutting.
Minimally invasive surgery often results in fewer post-operative infections and complications, resulting in better long-term results for patients. The surgery is generally performed in a matter of hours, and only in extreme cases require hospital stays of more than a few days.
- Muscles and soft tissues are spared.
- Risk of postoperative infection is decreased.
- Some procedures can be performed as outpatient surgery.
- Blood loss is reduced.
- Patients experience less postoperative pain.
- Reduced need for postoperative pain medication.
- Time hospitalized is reduced.
- Small incisions, cosmetically more appealing.
- Recovery is faster.
- Patients return to regular activities sooner.
The Recovery
Because the procedure requires so little disruption of surrounding tissue, patient movement is seldom restricted and recovery time is minimal. Advising a patient to remain in bed for a few days is counterproductive: they need to be walking around, and most begin physical therapy almost immediately. A great benefit of minimally invasive surgery is reduced recovery time and a shorter hospital stay. Less pain, scarring and fewer post-operative infections and complications are all advantages of the technique, which also reduces the need for a blood transfusion during the surgery. This, combined with better long-term results for patients, is a major reason for the procedure's popularity.

Conditions Treated with MIS
Not so long ago, all spine surgery was performed as an open procedure. Significant advances in surgical instruments, techniques, image-guided surgery, biotechnology (i.e. bone graft), devices, and implants have made MIS safe and effective in surgical spine care.
The following spinal problems are routinely treated using MIS : -
- Cervical and lumbar herniated discs.
- Degenerative scoliosis.
- Cervical and lumbar spinal stenosis.
- Spondylolisthesis.
What can I expect after surgery?
It is important to follow your doctor's instructions after surgery. Although many people feel better after just a short while, you may need to take it easy per your doctor's recommendation.
How will I know if minimally invasive spinal surgery is appropriate for me?
Every patient is evaluated individually. Consult with your doctor about the various treatment options available.
How safe is minimally invasive spine surgery?
If performed by experts in this field, minimally invasive spine surgery is as safe as "open" spine surgery in carefully selected cases.
This information is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
Minimally Invasive Endoscopic Spinal Surgery
Endoscopic surgery refers to the use of specialized video cameras and instruments which are passed through small incisions (less than 2 cm) into the chest, abdominal or joint cavities to perform surgery.
The benefits of endoscopic surgery are threefold. Since the size of the incisions are smaller, the recovery from surgery is much quicker. There is also less pain and less damage to the surrounding tissues.
Endoscopic techniques have been used for several decades, but these were exclusively for diagnostic purposes. 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 spinal disorders. In certain cases of degenerative disc disease, scoliosis, kyphosis, spinal column tumors, infection, fractures and herniated discs, endoscopic techniques may speed recovery, minimize post-operative pain and improve the final outcome.
By using special scopes, instruments and implants the orthopaedic spinal surgeons have been able to successfully treat some spinal column disorders with less injury to surrounding healthy tissue. Essentially the operations are being performed for the same conditions, however by using endoscopic techniques the recovery is more comfortable and quicker. What once required 3 to 6 months to recover from now only requires 3 to 6 weeks.
Not every patient, however, is a candidate for endoscopic spinal surgery. To see if you are a candidate for endoscopic treatment of spinal deformity, tumor, trauma, or degenerative disease you must be fully evaluated by a surgeon knowledgeable and experienced in these techniques.
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