Minimally invasive spine surgery is an endoscopic operation that utilizes specialized instruments that are entered into the abdomen or chest through tiny incisions in order to reach the spine and do the required surgery. This procedure involves the use of a specialized video camera as well.
For decades, endoscopic methods have been utilized but to diagnosis certain conditions only. In the later part of the 1970 and early part of the 1980s, there were advancements made to endoscopic techniques which allowed a diagnosis to be made and the disorder could be remedied. These techniques that are adopted in other surgical requirements have been developed to treat spine disorders.
However, a minimally invasive spine surgery is not perfect for everyone. A surgeon must completely assess each patient to identify their qualification for the surgery. In some cases of scoliosis, degenerative discs, kyphosis, herniated discs, fractures and infections, minimally invasive surgeries may accelerate recovery, alleviate post-operative pain and enhance the final result. The different types of minimally invasive spine surgeries are:
Spinal Tumor Decompression– This is performed to remove the whole tumor or part of it from the spine. This procedure decompresses or relieves spinal cord and nerve root pressure, thereby alleviating pain and other potential symptoms.
Minimally Invasive Lumbar Spinal Fusion-This procedure is aimed at fusing the two vertebrae to stop any motion between them. Removal of the intervertebral disc or bone spurs may minimize nerve pressure. When the two vertebrae are fused, the bone spur formation will be stopped at that certain location, further alleviating possible nerve injury and pain.
Discectomy is a procedure that is a removal of a herniated disc material that presses on a nerve root or the spinal cord. Before the removal of the disc material, a tiny piece of vertebral bone is removed. This is to enable the surgeon to have a better view of the herniated disc.
Benefits of Minimally Invasive Surgery
Compared to the conventional spine surgery that needs long incision and recovery period, minimally invasive surgery utilizes an endoscope that is inserted into a tiny incision. The endoscope is attached to a small video camera that projects the inner view of the body onto the operating room’s television screens. After the procedure, sutures are used to close the tiny incisions which will be covered with surgical tape. They will be almost invisible after a few months.
The fact that minimally invasive spine surgery holds a minimized risk of complications and alleviates the need for a longer stay in the hospital indicates that there could be cases that such surgical procedure can be performed on an outpatient basis. Obviously, this demonstrates substantial advantage for both patient and doctor in terms of cost effectiveness and safety. These procedures have become popular due to these mentioned advantages.
Minimally invasive spine surgery techniques use cutting-edge technology to make corrections to chronic spinal conditions without triggering undue injury to the soft tissues that surround it. Because of these highly specialized instrumentation and tools, guided by enhanced features like nerve monitoring and computerized navigation, spine surgeons are able to perform the surgery safely and effectively.
Compared to posterior lumbar fusion (PLF), a minimally invasive spine surgery like transforaminal lumbar interbody fusion (TLIF) provides the same postoperative fusion rates and alleviates the quantity of spinal muscle iatrogenic injury. The benefits of minimally invasive spine surgery include:
- Lower infection risk
- Minimized post-operative pain
- Alleviated blood loss
- Minimized scars
- Less body trauma
- Shorter recovery period
- Reduced or eliminated general anesthesia time
- Enhanced post-surgical mobility and function
Risks and Complications of Minimally Invasive Spine Surgery
Like any surgical operations, minimally invasive spine surgery has both procedure-specific and general risks. There are also cases that the original planned surgery will not be completed and must have a round of operation or a diversion from the minimally invasive technique to a full open approach.
- Adverse reactions to anesthetic
- Leg blood clot that can travel to the lungs causing pulmonary embolus
- Post-operative pneumonia
- Surgical site infection
- Blood loss that will require a transfusion
- Spinal cord or nerve injury that results in pain and paralysis in severe cases
- Possible breakage and malfunction of the instrumentation used that may irritate the surrounding tissues
- Surgical pain
Surgeons who are performing minimally invasive surgery usually would say that there is a limited opportunity to learn this technique. Post-operative and intra-operative problems are higher when the surgeon is obtaining experience. The technical challenges may be overcome with practice and training but it needs time.
Minimally invasive spine surgery requires advanced techniques, demands specialized equipment, offers decreased visualization and is linked to a limited learning curve. Compared to conventional surgical methods, this type of procedure is also related to minimized fusion rates and insufficient decompression.
The procedure does not need the utilization of fluoroscopy. This means a low chance of exposure to fluoroscopy. Actually, the risk is more for the part of the surgeon and staff in the operating room who are exposed to every patient. In minimally, invasive spine surgery, there is usually a risk of bone fracture, nerve damage, screw malfunction and blood clot formation.