What is Minimally Invasive Spine Surgery & How Effective is it?
Most spine injuries or conditions affecting this part of the body can be successfully treated with traditional treatments. In some cases, these treatments aren't helpful, and a patient needs surgery to find relief. We can categorize spine surgeries to two distinctive groups: invasive or open surgeries and minimally-invasive procedures. The latter have evolved immensely with the evolution of technology and science, and a majority of operations are performed that way. Throughout this post, you're going to learn everything that minimally invasive spine surgery entails.
What is Minimally Invasive Spine Surgery?
Minimally invasive spine surgery is a type of procedure which uses advanced technology and innovative techniques to treat neck and back pain caused by a multitude of spinal disorders and injuries. Back in the 1990s, non-invasive spine surgery was only used for certain problems that weren't demanding or severe. Thanks to the progress of technology and science, this procedure is performed for a broad range of problems nowadays with the same or even better efficacy as in open surgeries.1
Basically, the primary goal of minimally invasive spine surgery (MIS) is to stabilize the vertebral bones and spinal joints and/or relieve the pressure being applied to the spinal nerves.
Invasive vs. Non-invasive Surgery
To understand everything that minimally invasive spine surgery entails it is best to compare it to the open or invasive procedure. Open procedures require a large incision and therefore lead to a substantial blood loss. In these operations, the surgeon makes an incision that is 5 to 6 inches long and cuts or moves muscles to the side in a bid to see the spine and gain access to the affected area. These maneuvers result in a big scar and strong postoperative pain.
The procedure is lengthy just like the recovery. Unlike open spine surgeries, minimally invasive spine surgery approaches are faster, safer, and are associated with less blood loss and shorter recovery period. Minimally invasive spine surgery was invented to treat spine problems with less injury, pain, and struggles.
Due to the reduced trauma to the muscles and soft tissues compared to invasive operations, potential benefits of minimally invasive spine surgery are:
- Better cosmetic results from smaller incisions
- Faster recovery from surgery
- Less blood loss 2
- Decreased need for pain medications following the surgery
- The chances of muscle damage is considerably reduced
- Less rehabilitation
- Lower risk of infections.
It's also important to mention that costs of minimally invasive spine surgery are lower compared to invasive surgery. Another great advantage of minimally invasive spine surgery is the fact most procedures are performed in an outpatient setting meaning patients get to go home the same day.
How is Minimally Invasive Spine Surgery Done?
Minimally invasive spine surgery can be mini-open (operating through a small incision) and percutaneous (through the skin). Decompression procedures and spinal fusions are performed with special tools called tubular retractors. During the operation, the surgeon makes a small incision (1-1.5 inches long) and inserts tubular retractor to create a tunnel to the affected area. The purpose of this instrument is to hold the muscles open; other instruments necessary for the operation are inserted through the retractor. That way, there is no cutting or separation of muscles and tissues surrounding the affected area of the spine. Disc material or bone that has to be removed exits through the retractor.
The surgeon is usually guided by fluoroscopy to see where to make an incision and insert the retractor. Fluoroscopy displays real-time x-ray images of the patient's spine on the screen. In the end, the surgeon removes retractor and other instruments and closes the incision.
How Effective is Minimally Invasive Spine Surgery?
The Journal of Neurological Sciences published a study which showed that the effect of minimally invasive spine surgery on patients with low back pain is positive. They have less blood loss, faster postoperative ambulation, lower use of opioids; all these factors are better than in open procedures. The study also showed that minimally invasive spine surgery is cost-effective compared to invasive surgery.
A team of researchers from Norway carried out a study to examine the equivalence for clinical effectiveness between microdecompression and laminectomy in patients with central lumbar spinal stenosis. Results, published in the well-known BMJ showed that minimally invasive approach was equally effective to open surgery, but laminectomy group had more complications than microdecompression.
Furthermore, research from the journal Spine found that patients who underwent minimally invasive spine surgeries to alleviate back pain caused by conditions such as degenerative disc diseases and stenosis were better off than patients who had invasive operations.
Potential Complications of Minimally Invasive Spine Surgery
Every surgery comes with certain risks and potential complications, and minimally invasive spine surgery is no exception. Here are some risks associated with the procedure:
- Blood clots
- Infection 3
- Nerve damage
- Pain at graft site
- Recurring symptoms.
Bear in mind that this doesn't mean these complications will, indeed, happen.
How Long Does it Take to Recover from Minimally Invasive Spine Surgery?
As mentioned above, advantages of minimally invasive spine surgery include shorter hospital stay and faster recovery. While some procedures are performed in an outpatient setting, others require patients to stay in the hospital for two to three days. Postoperative pain following minimally invasive spine surgery is significantly lower compared to open surgery, but a patient still feels a slight discomfort.
Recovery period following minimally invasive spine surgery varies depending on the surgery performed, but following doctor's orders and physical therapy speed up the process. Some operations are associated with fast recovery and patient returns to work in a few weeks while fusion procedures might take several months; which is still shorter than in open procedures.
Which are the Most Commonly Performed Minimally Invasive Spine Surgery?
Two most frequent minimally invasive spine procedures are:
- MIS lumbar discectomy – removing disc to alleviate symptoms of herniated disc in lower back
- MIS lumbar fusion – reducing lower back pain
Non-invasive operation is also used to tackle the following:
FAQ on Minimally Invasive Spine Surgery
Who is Eligible for Minimally Invasive Spine Surgery?
Most surgeries nowadays take the non-invasive approach, but there are certain conditions which require standard, open procedure e.g. tumors, high-degree scoliosis, and so on. Based on the severity of disease, the doctor will recommend the suitable type of operation.
Is Minimally Invasive Spine Surgery Experimental?
No, minimally-invasive surgery has been successful for many years, and a multitude of scientific studies have confirmed its efficacy.
Do I Have to Wear a Brace?
Most patients are provided a brace, but it's usually for comfort and pain reduction only. Although the use of non-invasive techniques prevents one from wearing a brace, most patients report pain relief when they wear it.
Minimally invasive spine surgery has come a long way, and it is used to treat a majority of disorders and injuries affecting the spine. The efficacy of these procedures is proven by numerous studies, and the approach is cost-effective comparing to open surgery. Doctors also perform these operations because they are associated with shorter hospital stay and faster recovery.
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