Minimally invasive spine surgery known as M.I.S.S is an option to traditional open surgical procedures, as well as an alternative when non-surgical approaches are working but the pain or condition is becoming worse, regardless. These are performed to treat a variety of spinal disorders like:
- Bone spurs
- Degenerative disc disease
- Herniated disc
- Scoliosis
- Spinal instability
- Spinal stenosis
- Spinal tumors
Minimally invasive surgery can offer potential benefits. These include
- A small/tiny incision/s
- Minimal cutting through soft tissues like ligaments, and muscles
- Outpatient option/s
- Reduced post-operative pain
- Quicker recovery
The Focus of Spine Surgery
There are two main goals when it comes to spine surgery or rather the goal/focus of the surgery. These are decompressing and stabilizing the spine.
Decompression of the spine
Spinal decompression involves removing any tissue/s that are compressing/pinching the nerve structures like a spinal nerve root or the spinal cord itself. Bone spurs and fragments from a herniated disc are the types of tissue/s that can cause neural compression.
Stabilization of the spine
An abnormal movement of one or more levels/segments of the spinal cord can cause back pain, neck pain, or both. Surgeries that are meant to stabilize and stop these abnormal movements utilize spine instrumentation combined with fusion.
Spine Surgery Techniques
Minimally invasive spine surgery techniques include:
- Percutaneous or through the skin
- Mini-open or small incision procedure/s
Rather than cutting through soft tissues, a tubular retraction instrument generates a tunnel that expands and passes between the muscle/s to access the spine's column. Then an endoscope or a tiny video camera goes in and around the area, projecting a visualization of what's happening on a monitor during the procedure.
This is the surgeon's/team's eyes as they work to repair the damage. The surgery is run through the tubular retraction system along with any specially designed instruments that are needed. Types of surgical procedures performed with minimally invasive surgery include:
- Discectomy
- Microdiscectomy
- Foraminotomy
- Microforaminotomy
- Microlaminectomy
- Microlaminotomy
The micro means that the surgery is done using a special microscopic camera to view the disc/s and nerve/s. Imaging scans, systems, and image-guidance technologies, like fluoroscopy, which is a real-time x-ray are utilized during the surgery pinpointing the key aspects of the patient’s spinal anatomy. The surgical imaging shows 2D and 3D views, which guides the placement of any instrumentation, like pedicle screws.
Disorders Treated with Minimally Invasive Surgery
Degenerative disc disease
Degenerative disc disease is known as DDD often develops progressively in older adults and affects the intervertebral discs. The normal wear and tear of cellular age-related changes in the body can cause the spine's discs to:
- Stiffen
- Lose Flexibility
- Loss of Strength
- Loss of Height
- Lose shape, along with the ability to absorb/distribute the forces associated with moving
These structural changes increase the risk of disc herniation and subluxations.
Herniated discs
A herniated disc also called a slipped, bulging, and ruptured disc. This happens when the soft gel cushion of a disc breaks through the protective outer layer. Other than the damaged disc, the loose interior gel can also irritate and inflame the nerves causing back pain.
Scoliosis
Scoliosis is an abnormal sideways curve of the spine that can cause progressive spinal deformity. A scoliotic curve can look like an “S” or “C.” Most cases have no known cause, and while the condition is more commonly associated with children, adults can develop scoliosis, as well.
Spinal stenosis
Spinal stenosis happens when the spinal nerve roots and the spinal cord become compressed/pinched. These nerves branch off the spinal cord and exit the spinal canal through passageways called neuroforamen. Nerve and spinal cord compression can cause symptoms like:
- Pain
- Weakness
- Tingling sensations
- Numbness
- Sometimes, pain can travel into the arms or legs
Spine Surgery Risks
With any spine surgery there are potential risks and complications that can occur. Here are some possible complications that can happen during and after surgery, with both open and minimally invasive procedures.
- Bleeding
- Blood clots
- Failed fusion pseudarthrosis/non-union
- Nerve damage
- Symptoms come back
- Infection/s
Candidate for Surgery
Minimally invasive spine surgery does offer many benefits:
- Tiny incision
- Less pain
- Reduced risk
- Faster recovery
Let's not forget that M.I.S.S is still surgery. Less than 5% of people with back or neck pain need spine surgery and, surgery is the last resort for treating pain and symptoms caused by a spinal condition/disorder.
It is only when non-surgical treatments like chiropractic, acupuncture, physical therapy, medication, or spinal injections do not reduce symptoms in 3 to 6 months. This is when you qualify to be a candidate for spine surgery. There are certain types of spinal disorders that require urgent or immediate surgical intervention.
Talk with your doctor, chiropractor, or spine specialist about the pain, the symptoms, and compare the results of the different therapies/treatments and go from there. With any type of surgery there are many considerations to discuss before making a decision to treat back or neck pain and if minimally invasive surgery could be an option.
