Minimally Invasive Spine Surgery: Benefits, Candidates, and Procedures

03 May,2024

Undergoing spine surgeries was a traumatic experience back in the day. It was rightly so due to the low success rates and higher postoperative complications. But that’s not the scenario anymore. Today, approximately 3 to 5 million spine surgeries are done annually worldwide.

One of the primary reasons patients have started trusting surgeons with spinal procedures is the improvements in surgical techniques. Minimally invasive spine surgeries have revolutionized the field of neurosurgery. Surgeons make an incision smaller than 2 cm, leaving the surrounding muscles and soft tissues unharmed. It helps patients recover quickly and minimizes the risk of complications.

Patients can now expect a success rate of 70 to 90% with minimally invasive spine surgeries. Read the blog further to learn about the procedure, suitable candidates, and benefits.

What is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery (MISS) involves making small incisions in the skin rather than a single large incision, which is typical of open surgery. 

During open surgery, a significant amount of muscle and surrounding soft tissue may be moved or removed from the bone to allow the surgeon a clear view of the surgical site. It causes more muscle damage and pain after surgery. 

In contrast, minimally invasive surgery involves using a small metal tube or endoscope inserted through the small incisions to allow the surgeon to work through a smaller operative field. This results in much less damage to muscles and soft tissues than a single long incision.

How Does Minimally Invasive Spine Surgery Differ From Traditional Open Surgery?

Minimally invasive spine surgery (MISS) is a better option than traditional open spine surgery and offers several benefits. The main differences between MISS and open spine surgery are as follows:

• Incision Size: Minimally invasive techniques use smaller incisions, typically less than 2 inches, while traditional open spine surgery requires larger incisions of 4-6 inches or more.
• Muscle Disruption: MISS causes less muscle disruption than open spine surgery, which involves more muscle retraction.
• Blood Loss: MISS causes less blood loss, whereas traditional spine surgery often causes more.
• Pain: Patients who undergo MISS experience less postoperative pain than those who undergo traditional approaches.
• Hospital Stay: MISS often requires shorter hospital stays, with some procedures being done on an outpatient basis. In contrast, open spinal surgeries require hospitalization for 3 to 7 days.
• Recovery Time: Patients undergoing minimally invasive spine surgeries recover faster and can return to daily activities quicker than those undergoing traditional surgeries.

Who Requires Minimally Invasive Spine Surgery?

Not everyone with back pain requires surgery. The primary criteria for determining whether you're a suitable candidate for MISS are the same as those for traditional open surgery. 

Your healthcare provider may recommend spine surgery when nonsurgical treatments, such as physiotherapy and medications, have not relieved the symptoms caused by your back problem. If you are suffering from excruciating pain, spine surgery might fix the problem.

Additionally, your doctor will consider surgery if they can identify the source of back pain, such as spinal stenosis or a herniated disc.

However, not every disease can be treated with minimally invasive spine surgery. The surgeon will advise spine surgery only if you have a condition that MISS may help with. This includes disorders such as:

• Herniated disk
• Spinal instability
• Spondylolisthesis (when a vertebra slips forward)
• Spine tumor
• Fractured vertebra
• Spinal stenosis (narrowing of the spinal canal)
• Spinal deformities (like scoliosis)
• Spondylolysis (a defect in lower vertebrae)
• Infection in the spine

If you're considering spine surgery, it's essential to ask your surgeon if minimally invasive spine surgery (MISS) is an option. Keep in mind that not all types of spine surgery can be performed with MISS, and not all hospitals are equipped for MISS.

What are the Types of Minimally Invasive Spine Surgeries?

Microdiscectomy

• This procedure targets a herniated disc, the soft cushion between your vertebrae that can bulge or break outward and press on a nerve. 
• During a microdiscectomy, a surgeon makes a small incision and uses a microscope to visualize the area. 
• They then carefully remove the protruding part of the disc to relieve pressure on the nerve. 
• It can help alleviate pain, numbness, and weakness caused by the herniation.

Laminotomy/Laminectomy

• This surgery aims to create more space in the spinal canal, the hollow area within your spine that houses the spinal cord and nerves. 
• The lamina is the bony roof covering the spinal canal's back. 
• A laminotomy removes a small part of the lamina to create extra space. 
• In a laminectomy, a larger section of the lamina is removed for more extensive decompression. 
• It can be helpful for spinal stenosis, where the spinal canal tapers and compresses the spinal cord and nerves.

Foraminotomy

• This procedure focuses on the foramen, a small opening on either side of the vertebrae where nerves exit the spinal canal to reach other body parts. 
• Bone spurs, bulging discs, or thickened ligaments can sometimes narrow the foramen and pinch the nerves. 
• During a foraminotomy, the surgeon removes a small amount of bone or ligament to enlarge the foramen and free the pinched nerve. 
• It can help alleviate pain, weakness, and numbness radiating along the route of the affected nerve.

Spinal Fusion

• This surgery permanently binds two or more vertebrae together to improve stability and prevent excessive movement. 
• The surgeon uses the spinal fusion technique for conditions like spondylolisthesis (where a vertebra slips forward on another) or severe degenerative disc disease (where the discs between vertebrae lose their height and function). 
• During minimally invasive spinal fusion, the surgeon inserts bone graft material (often taken from your hip bone) between the vertebrae and sometimes uses small screws or plates to hold them together while the graft fuses and heals. 
• It creates a solid structure and reduces pain from excessive motion.

Vertebral Augmentation

• This procedure strengthens a fractured vertebra. Vertebral fractures can cause pain, deformity, and instability in the spine. 
• During vertebral augmentation, the surgeon injects bone cement (a special type of medical-grade quick-drying concrete) into the fractured vertebra. 
• It fills the cracks and helps stabilize the bone, reducing pain and improving function.

What are the Benefits of Minimally Invasive Spine Surgery?

Keyhole or minimally invasive spine surgeries offer several benefits over traditional open spinal procedures. Some of these are –

• Less pain 
• Less anesthesia
• Quicker recovery 
• Shorter hospital stay
• Less dependency on pain medications 
• Reduced blood loss during surgery
• Reduced risk of infection and postoperative complications
• Smaller scars and better cosmetic results
• Less damage to soft tissues and muscles
• Less rehabilitation required
• Faster return to normal activities and work

MISS has gained significant popularity in recent years because of these advantages. If you are fascinated with benefits such as fewer postoperative complications and faster recovery, visit a spine surgery hospital today!

What are the Latest Advancements in Minimally Invasive Spine Surgery?

There have been significant breakthroughs in traditional spine surgeries. With the success of minimally invasive spine surgeries, researchers are now trying to improve the procedure further. Some of the advances in minimally invasive spine surgery are –

• Endoscopic Spine Surgery: Due to the improvements made in endoscopes (thin tubes with camera lenses and light sources), surgeons now have better visibility, light, and 3D depth perception. A minimally invasive approach is now an option for more patients as various surgical equipment can be inserted with the endoscope. Endoscopic spine surgery is a good option for people who have been advised spinal fusion and decompression.
• Robotic Spine Surgery: Another advancement in MISS is using robotic systems. Surgeons can now access the spine using computer-guided robotic arms. A common misconception with robotic surgeries is that the robot performs the surgery. That's not true. The surgery is done by the spine surgeons, who operate the arms of the robot using a computer. Robotic spine surgeries are safer and more accurate.

To Conclude

In conclusion, minimally invasive spine surgery (MISS) has revolutionized the field of spine surgery. MISS offers significant advantages over traditional open spine surgery with smaller incisions, less muscle disruption, and faster recovery times. If you're suffering from chronic back pain that hasn't responded to conservative treatments, talk to your doctor to see if MISS might be a suitable option for you. Remember, timely diagnosis and treatment are critical to a successful outcome. Schedule a consultation with a spine surgeon today to discuss your treatment options.