Minimally invasive spine surgery (MISS) is an operation performed on the vertebrae with minimal incision. It does less harm to the tissues and promotes faster rehabilitation. And if the traditional open back surgery involves a long incision with the separation of muscles and soft tissues, then for minimally invasive spinal surgeries only a small tunnel is required to insert the tubular retractor into the problem area.
Many people with back pain don’t require intervention and may well get by with non-surgical treatments. However, if the spine condition doesn’t improve for a long time, the rheumatologist may recommend an operation. That’s not a panacea, and it won’t be able to solve all kinds of spine difficulties; nevertheless, when diagnosing certain conditions, you cannot do without it.
MISS advantages
- Some MISS can be performed on an ambulatory basis using local anesthesia.
- Better wound healing due to minimal skin incisions, sometimes reaching several millimetres.
- Less blood loss, in contrast, to open operations.
- Lower risk of muscle damage.
- Infection of the wound is practically impossible.
- Possibility of quick rehabilitation after the operation.
- No dependence on painkillers.
Conditions that are treated with minimally invasive surgery
If you’ve been experiencing severe pain for a long time and the non-surgery approach is ineffective, your physician may advise an operation. Let’s take a look at the most common conditions requiring intervention.
Degenerative disc disease (DDD)
DDD often affects the intervertebral discs of the cervical or lumbar area of not only the elderly but also young people. The root cause is at the cellular level when the discs lose elasticity and strength, and impacts can lead to rupture or herniation.
Herniated disc
The disease is often referred to as displacement or rupture of the intervertebral disc. It occurs when the nucleus pulposus (gelled disc material) flows out through the annulus fibrosus. The substance spreads and presses on the spinal nerves, causing inflammation.
Stenosis
That’s a narrowing of the neuroforamen, often affecting the cervical and lumbar areas. The disease affects the elderly and appears in compression of nearby nerve roots. As a result, a patient feels numbness, tingling, and weakness.
Spondylolisthesis
A condition in which the vertebral bodies slide over the surface of each other. Depending on the shift, the disease progression can be assessed on a scale from 1 to 5, where the last one is most severe.
Spinal deformities and instability
Scoliosis and excessive lordotic and kyphotic bends can affect the mobility and flexibility of the spine.
Vertebral compression fracture (VCF)
That’s a common type of fracture that occurs due to osteoporosis and trauma. Sudden, sharp pain is the main symptom.
Spine tumours
Abnormal growth of tissue can occur in any part of the spine. That’s the primary tumor. When there’s a migration process from another organ, such as the lung, it comes to a metastatic spine tumor. It can be benign or malignant.
Spread of infection
There’s a high risk of infection after surgery or injury. It arises in the vertebral body or affects the intervertebral discs. Therefore, constant pain at the site of injury is an alarming symptom of a spinal infection.
If you consider the operation an opportunity to get rid of pain, consult your doctor about MISS and whether it’s possible to perform this manipulation at the center where you’re receiving treatment.
Risks of minimally invasive spine surgery
Any surgical procedure carries risks. For minimally invasive intervention, the following complications are possible:
- Infection
- Bleeding
- Thrombosis
- Nerve damage
- Complications after anesthesia
- Pain at the site of surgery
- Cerebrospinal fluid leak
Depending on age, the risk of complications increases. Nevertheless, preoperative preparation will play a crucial role during the rehabilitation period. The better your muscle tone, the faster you can recover.
MISS treatments
Many operations performed by unconventional technicians can be achieved with minimal incisions. Let’s consider the most common ones.
- Discectomy
- Vertebroplasty or kyphoplasty
- Laminectomy
- Spinal fusion
- Implantation of instrumentation
- Artificial disc replacement
Implanting the TOPS system is a minimally invasive procedure since it doesn’t require making a large open incision in the back.
MISS preparation
Having decided on an operation, you need to inform your doctor about all medications you’re taking. We’re even talking about those that are dispensed without a prescription (aspirin) or anticoagulants. Monitor any changes in your body: even a temperature rise can affect the surgeon’s decision to operate.
It’s essential to get rid of bad habits – smoking, alcohol, and drugs. They’re factors that cause inflammation and slow down the recovery process.
You may need an MRI and X-ray before surgery. That can also become a severe test in the future if the implant material is unacceptable for the procedures.
It’s not recommended to eat or drink on the eve of the operation.
How does the intervention process perform?
MISS is performed by an orthopedic surgeon as well as other medical experts. Depending on the state of health and the degree of the operation complexity, it may begin with anesthesia, numb the operable area. You’ll start to fall asleep, and in the meantime, doctors will monitor vital indicators – heart rate and blood pressure. You can also take antibiotics before and after surgery to prevent infection.
The surgeon will make a small incision in the previously treated area of the back and insert a tubular retractor. Through a tiny camera, the specialist will be able to see the naked spine. During the posterior arthroplasty procedure, the bone elements are removed, creating a compression of the nerve roots. In general, the duration of the surgery may vary depending on the implants. The average time of the implementation of the TOPS system is 93 minutes (60-120).
Rehabilitation
The implementation of the TOPS system provides for a quick recovery: the very next day after the operation, you can get up and work with a physiotherapist. You can also go home if you’re feeling well.
Some pain may be felt after the surgery – it can be alleviated with pain relievers.
After a few weeks, you’ll return to regular activity and even sports, but the preoperative period is essential. It’s about preparing the body for surgery – maintaining and improving muscle tone will improve blood circulation and become one of the most critical factors in recovery.
Takeaway
By following your doctor’s instructions, you’ll always be able to achieve better health. The main thing is to hear your body so that the disease diagnosis will be more accurate, and the decision about the operation will be justified. MISS is an alternative to traditional surgery as it provides a minimal incision area, quick healing, and recovery of the body. The high-tech nature of the operation eliminates a considerable number of risks of complications, which significantly simplifies the life of patients and facilitates the work of specialists.
Adam Mulligan did his degree in psychology at the University of Hertfordshire. He is interested in mental health and well-being.