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All You Need To Know About Minimally Invasive Spine Surgery

Minimally Invasive Spine Surgery

  • 2021-10-10

Nowadays to treat different spinal disorders, such as herniated disc, scoliosis, degenerative disc disease, and spinal stenosis surgeons use Minimally Invasive Spine Surgery.

The minimally invasive spine surgery occurs on the spinal bone. Doctors recommend this process in preference to the standard open backbone surgery.

The procedure requires small incisions. 

Doctors try over tiny apparatus for the surgery. The procedure causes less harm to the adjacent muscles and other nearby tissues.

Patients also like to have the process. 

It never creates pain. You will enjoy a faster recovery, too.

Besides those, MISS offers several other potential benefits. It is a safe process.

You can expect:

  • Better cosmetic results from smaller skin incisions. Surgeons make these before conducting the process.
  • Lesser or no bleeding.
  • No blood clotting.
  • Surgeons do not cut muscles. Therefore, the procedure leaves trivial scope for muscle damages.
  • Infection is natural in any surgery. For MISS, the percentage is negligible.
  • Post-operative pain risk is low. Thus, you will not have to rely much on pain medications.
  • Your rehabilitation period is also less. You can compare this to other similar surgeries.
  • The surgical doctors use local anesthesia. The allergy effect from anesthetic medicines is thus absent in MISS.

 

Surgery Reasons

You have back pain. It does not mean that you will need surgery for recovery. Your doctor will ask you to contact an orthopedist when the back problem sustains for a prolonged period. 

Medicine and physical therapy could not bring about recovery.

You must know that spinal operation does not offer a solution for all diseases. Therefore, your doctor checks your condition vividly. He recommends MISS if it seems fit. 

You may require minimally invasive spine surgery to recover from the following diseases.

  • Spine Stenosis. The spinal canal narrows under this condition.
  • Herniated Disc.
  • Deformities in the backbone cord. Doctors call it scoliosis.
  • Instability in your vertebrae.
  • Spondylolysis; a defect in a lower vertebrae portion that causes the condition.
  • If a vertebra sustains a fracture.
  • When the doctor feels to remove a tumor from your spine.
  • Backbone infection.

Please do not forget to ask your doctor before you decide to go for a MISS method.

 

How MISS works

Spinal nerves, vertebrae, and discs are deep-rooted in our bodies. Thus, surgeons need to remove the muscle tissues in between our body surface and backbone region. 

It enables them to have access to the back areas.

They do it by using small incisions and guiding instruments. The minuscule instruments usually carry a video camera. 

The camera takes inside pictures and sends those to a video monitor in a nearby zone. The operating team follows its guideline to reach the spinal region.

The patient may feel extreme pain during this procedure. Surgeons use selective methods to offer the patient some relief. These include:

 

Use of a Tubular Retractor

It is a soft tissue dilation technique. Doctors use the progressive method instead of cutting through the muscles.

In this method, they use a tube to keep the muscles out of the way. It also helps the surgeons to work through the incision without making wider area exposure.

At times, they also focus down a microscope or endoscope. It works in resolving the purpose through a minimal access strategy.

The surgical team removes the tubular retractor when the procedure is over. Thus, the dilated tissues reinstate into their positions.

 

Placing screws and rods

Sometimes, your backbone may require stabilization or immobilization. Surgeons use screws or rods to fix it.

It also facilitates spinal bones fusion. Currently, they use percutaneous methods to do this.

The percutaneous method involves inserting screws or rods through small incisions made on the skin. Thus, the surgeon avoids cut or dissection through the muscles. 

The treatment team places guide wires through the skin into the spinal vertebrae. 

Screws follow the wire path but stay over these. 

These have temporary extenders. They stretch outside the wire.

The operating surgeon removes these as the rods can connect and secure the screws. You can place the spiral instrumentations with the desired accuracy with the help of these guide wires.

 

Choosing a lateral direct access route

The surgical doctors adopt a side-way approach to the spine while offering treatment to the lumbar spine. This area contains a lesser amount of muscle tissue. Therefore, it seldom causes pain.

 

Opting for the thoracoscopic access route

Sometimes, the surgeon requires accessing the thoracic spine facade.

The procedure is more terrible than other methods. 

The heart and lungs surround the area in the chest.

He makes several small incisions on the zonal edge. The working ports and cameras pass through these cuts and help in safe surgery conductance.

 

Treatment Options

Doctors deploy several methods for MISS surgery. Some of the most used approaches include:

Discectomy

The soft materials in the spinal disc are herniated as the elastic rings within these weakens. The materials within the disc compress the nerves around, causing pain thus.

Your doctor may recommend minimally invasive spine surgery. With the help of tubular dilators and a microscope/endoscope, the surgeon repairs the weakened rings.

Spinal Decompression

Spinal stenosis causes this. It involves the vertebral canal narrowing that compresses the nerves. 

You can get a host of symptoms with this. These include:

  • Muscle weakness.
  • Pain.
  • Numbness.

With a MISS procedure, the doctor removes the bone and soft tissues, causing such compression.

Transformational Lumbar Inter-body Fusion

Sometimes, spondylolisthesis also causes refractory low back and radicular pain. Similar pains generate with recurrent disc herniation and degenerative disc conditions.

TLIF is a well-known minimally invasive spine surgery method to cure such trauma.

Your surgeon will do the surgery on the stomach from the posterior zone.

He will make two small incisions on your back to insert screws and rods.

The instruments remove the intervertebral disc. Then the doctor places a cage filled with bone in the void.

These implanted bones help stabilize the levels.

 

Spinal Fusion

The surgical procedure helps create a solid union between vertebrae. It stabilizes the spine too. You can trust the method to reduce severe and chronic back pain effects.

Doctors place a bone graft between vertebrae. The graft works to establish and stabilize their union.

They use the patient’s hip or another bone to collect the grafts. Sometimes, a bone bank also helps.

The surgical team depends on bone graft extenders and bone morphogenetic proteins when the other two attempts do not work.

Presently, surgical doctors use the latter methods more pervasively. Using a bone graft may cause physiological complications.

 

The Minimally Invasive Spine Surgery fusion procedures

These include:

  • The Minimally Invasive Lateral Inter-body Fusion.
  • A Minimally Invasive Posterior Lumbar Inter-body fusion
  • Trans-foraminal Lumbar Inter-body Fusion. It is also a minimally invasive procedure.
  • A Minimally Invasive Posterior Thoracic Fusion.

Who is an appropriate candidate?

Doctors search for specific indications before referring a patient to MISS treatment. Also, they customize the surgery processes for the patient and the technique.

Your spine care team may also decide that there are other treatment options while conducting the evaluation process.

They recommend their uses before suggesting surgery.

Preparation

Consult with your physician regarding the preparation. He will ask about your hobbies and preferences.

Many of us use several over-the-counter medications to combat various trivial psychological effects. Give your doctor a list of the medicines and supplements you intake for several reasons.

It is mandatory. Your doctor will ask you to stop some of those well ahead of the surgery. The exclusion will include blood thinners.

Stop smoking immediately. It delays the healing and recovery procedures.

The operating doctor will order several X-rays while preparing for the surgery. You will also require a Magnetic Resonance Imaging test during this time.

Mention any recent changes in your health in the recent past. Do not forget to mention fever, cough, and cold, etc.

Consume nothing after midnight of the MISS appointed date. You should not drink water for the last six hours preceding the operation.

Expectation during the surgery

An orthopedist performs these types of surgeries. The clinic appoints a trained medical team to assist the surgeon.

Your healthcare provider will tell the details. You can assess the probable expectation from the discussion.

  • Your surgeon performs the surgery under local anesthesia. It will numb several body parts.
  • The treatment team will also give you sedation. It will make you relaxed but awake during the operation.
  • You can also choose general anesthesia. Your doctor will encourage you if you have no allergic inclination towards anesthetic medicines.

It will prevent pain. You will stay asleep through the surgery.

  • A technical team member will carefully watch the vital signs. These include heart rate and blood pressure.
  • The medication during anesthesia will also accompany antibiotics. These help prevent infection.
  • The surgeon uses a special X-ray. It helps view the surgery.
  • Then the surgeon makes a small incision in the posterior near the treatment area.
  • He puts a tubular retractor in the incision. It exposes the spinal part under treatment.
  • Then he passes a tiny camera and a light through this retractor.
  • With this, he starts spine repair.
  • The surgeon removes the tools and retractor after the procedure. 
  • Cuts are closed with stitches, glue, and staples. Then he puts a small bandage on the wound.

Incidents

  • Inpatient recovery time for MISS is often significantly shorter than regular surgery. There are differences in release time too. Some patients go home within a few hours after surgery.
  • Orthopedic patients may require physical therapy before going home.
  • Patients have a shorter overall recovery time. It is unique in Minimally Invasive Spine Surgeries.  
  • MISS takes almost half compared to the traditional surgery processes.
  • Usually, patients do not require any hospital stay.
  • The recovery period can extend up to six weeks.
  • MISS causes less pain than traditional methods. These are less disruptive to unrelated tissues and muscles.
  • However, there are several discomforts associated with MISS. Therefore, the surgeon and his medical team develop an appropriate treatment plan to manage pain.
  • The purpose of minimally invasive spine surgery is to minimize the damage and strain on the body.
  • Be careful to keep the area clean. The specialist team will help you in the process. 

 

Benefits and Risks

Benefits

MISS offers several advantages over the open processes. These include:

  • Usually, doctors use local anesthesia.
  • Lesser or no bleeding during surgery.
  • No blood clot.
  • Muscle and soft tissue damages do not occur.
  • Minimum infection chances.
  • Less after-surgery pain. Doctors thus seldom recommend pain medication.
  • It results in a few tiny scars. It involves better cosmetic results.
  • The patients need not stay in the hospital for long.
  • Faster recovery time.
  • They can get back to usual activities within a short period.

Risks

Minimally Invasive Spine Surgery involves two types of risks. These include:

General surgery risks

  • Patients may have an allergic reaction to the anesthetic medicines.
  • Pneumonia. It usually occurs post-procedure.
  • Blood clots. It happens seldom. Usually, it starts on the legs and traverses to the lungs.
  • Infection.
  • Blood loss while the process is in progress. It may also require a transfusion.

Specific Risks for MISS

These include:

  • Nerve injury or spinal cord damage. It may result in pain or paralysis.
  • Damage to the surrounding tissues.
  • Pain from the surgery.
  • A leak of spinal fluid.

 

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