Minimally Invasive Spine Surgery

Minimally invasive spine surgery, also known as MISS, is any minimally invasive procedure that targets conditions specifically within the spine through the use of small incisions as opposed to traditional open-spine surgery which typically requires a 5-6 inch incision. This technique utilizes modern technology, advanced imaging techniques and special medical equipment to reduce tissue trauma, bleeding, radiation exposure, hospital stays and recovery by minimizing the size of the incision.

MISS can be used to treat a number of spinal conditions such as degenerative disc disease, disc herniation, fractures , tumors , infections, instability and deformity. It also makes spine surgery possible for patients who were previously considered too high risk for traditional surgery due to previous medical history or the complexity of the condition.

Traditionally, spine surgery has been performed using the "open surgery" method This procedure requires surgeons to create a 5-6 inch incision down the affected portion of the spine and to pull back the tissue and muscle using retractors in order to reveal the bone. Open surgery can affect more anatomy than is actually required to operate on the spine and can lead to lengthier recovery periods.

Minimally invasive surgery aims to combat these issues by reducing tissue trauma, bleeding and risk of infection while improving the healing process of the body by minimizing the size of the incision.

Minimally invasive spine surgery is performed by an orthopedic surgeon and a trained medical team. Typically, they will begin the operation by delivering a type of anesthesia that numbs a particular part of the body in conjunction with sedation or simply give a general anesthesia that prevents pain and allows the patient to sleep throughout the surgery.

Next the surgeon will begin taking fluoroscopic images on the affected portion of the spine. This will allow them to see exactly what they're operating on, in real-time, throughout the surgery without creating a large incision.

At this point, the surgeon will begin performing the operation percutaneously, meaning "through the skin", by creating an incision of about 15mm above the affected portion of the spine. This will provide enough room to allow the insertion of a tubular retractor, a small, rigid tube, which will allow the doctor to put small operating tools down into the spine as well as endoscopic cameras and a light.

Next, the surgeon will make the necessary repairs to the spine, extracting affected disc material out through the tubular retractor and inserting devices (like screws) through the tubular retractor. Once the repairs have been completed, the tools and tubular retractor are removed from the back and the surgeon closes the incision using stitches, glue or staples.

While minimally invasive spine surgery can offer numerous benefits, there are still risks involved in undergoing the procedure. One of the most prominent issues with the procedure is the learning curve that surgeons must overpass in order to properly perform the surgery. MISS is a complicated operation that requires precision and knowledge not needed in traditional open surgery. This being the case, surgeons need to have an extensive knowledge of minimally invasive procedures as well as the tools needed to perform them properly.

Another risk that patients face when undergoing minimally invasive spine surgery is the potential for damaged nerves. Since incision sites are so small, surgeons can occasionally have a difficult time seeing exactly what they're operating on and risk damaging the spinal nerves in the process.

Radiation exposure has been cited as another risk of minimally invasive spine surgery. Surgeons will often use fluoroscopic imagery throughout the procedure in order to see what's happening in real-time. However, since fluoroscopes use X-rays to penetrate skin, patients and operating room staff are exposed to radiation.