HOW DOES MINIMALLY INVASIVE SURGERY WORK?
If you and your doctor decide that back surgery is the right option for you, know that advancements in spine surgery have made these procures far less invasive, with significant advantages. The procedures achieve similar results as traditional surgery, but minimally invasive surgery (MIS) approach means:
- Less cutting of muscles and skin1,2,3
- Smaller scars4
- Decreased blood loss1,2,3
- Shorter length of hospital stay1
WHAT HAPPENS DURING A MINIMALLY INVASIVE SPINE PROCEDURE?
Unlike traditional spinal surgery, which requires incisions up and down the middle of the back and muscle retraction, a minimally invasive procedure uses tiny cameras and smaller skin incisions. Surgeons are able to work precisely in smaller surgical fields.
With the use of dilator tubes, the surgeon will access the lumbar spine through small skin incisions and tunnels created by separating muscle along its natural divisions. Following placement of bone graft, the surgeon uses a special “live action” x-ray machine called a fluoroscope to visualize the spine and determine where to place the screws.
A stiff guidewire is inserted through skin and muscle to the screw insertion point on one vertebra. The dilator tubes are slowly passed down over the guidewire, creating tunnels through the muscle to the target screw placement area. A screw attached to a screw extender is inserted through the muscle to the vertebra. The process is repeated for each screw.
A minimally invasive system is then used to insert the rods through the screws. The separated muscle flows back together, and the skin incisions are closed, leaving only thumbnail-sized skin incisions.
WHAT CAN I EXPECT AFTER SURGERY?
In most cases, immediately after surgery your heart and lung function will continue to be monitored and your doctor may prescribe medication to control pain and nausea. A nurse will show you how to care for your incisions before you are sent home and your doctor will discuss a program to gradually increase your activity. You may be required to wear a back brace after surgery and you may be told to avoid repetitive bending, lifting, twisting and athletic activities while you recover. You may also be cautioned to avoid vibrations, such as those you might experience when driving a car, for a period of time after your surgery. Your doctor will schedule office visits to check on how you are doing and see if anything else needs to be done. You may be referred to physical therapy.
Contact your doctor immediately if you get a fever, your incision leaks fluids, you have increase back or leg pain or numbness, or if you have trouble breathing, swallowing or urinating.
Ask your doctor about your specific recovery plan following surgery. It is important to follow your doctor’s instructions carefully to recover from surgery as quickly as possible and increase your chance of a successful outcome.
How fast you recover depends on the type of surgery you had, your commitment to working closely with your physical therapist, and moving and exercising correctly, as recommended by your surgeon.
WHAT ARE THE POTENTIAL RISKS OF MINIMALLY INVASIVE BACK SURGERY?
Potential risks to any surgical procedure include unforeseeable complications caused by anesthesia, blood clots, undiagnosed medical problems, such as silent heart disease, and rare allergic reactions.
Some risks of spinal surgery include incomplete pain relief, damage to the nerve roots, infection, and complications with the hardware. Most of these complications can be treated once they are detected, but sometimes they require a longer period of hospitalization or recovery, additional medications, and sometimes even additional surgery.
Depending upon the type of surgery you are having, these risks will be explained by the primary surgeon. In general, these complications happen very infrequently, but it is important to remember that surgery is a difficult process, and, therefore, unforeseeable complications do occur. As a patient, it is important to understand and follow your doctor’s advice so that the best possible outcome can be achieved.
Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.
1
McAfee, et al. Minimally Invasive Spine Surgery. Spine, 35(26S): S271-273, 2010
2
Khoo LT, Palmer S, Laich DT, Fessler RG. Minimally invasive percutaneous posterior lumbar interbody fusion. Neurosurgery. 2002 Nov;51(5 Suppl):S166-S181.
3
Park Y, Ha JW. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. Spine. 2007 Mar 1;32(5):537-543.
4
Righesso. Comparison of Open Discectomy with Microendoscopic Discectomy in Lumbar Disc Herniations: Results of a Randomized Controlled Trial. Neurosurgery. 61:545-549, 2007.
