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Overview

Spine surgery is recommended to the patients suffering from severe pain in leg, lower back, neck, or arm. Spine surgery is usually prescribed in cases where basic treatments like medication, physical therapy and injections fail to provide the desired result. Spine surgery can be performed as either an open surgery or as minimally invasive surgery. In an open surgery, the surgeon makes a large incision in order to provide a clearer view and easier access to the area to be operated. However, in minimally invasive technique, the area to be operated is accessed through a smaller incision. This is made possible by the use of special surgical instruments and advances in medical techniques. The goal of minimally invasive spine surgery is to provide the patient with less pain after the surgery and a shorter recovery time. Other than the health benefits, the minimally invasive spine surgery also has lower overall cost compared to the open surgery.

 

Traditional Open Surgery

During an open surgery an incision of around 5-6 inches is made on the abdomen. The muscles and organs are moved out of the way so that the surgeon can see the spine properly. As the muscles and organs are pulled apart, the surgeon has easy access to the damaged part/parts of the spine. Moreover, the large incision helps the surgeon to see where to place the screws, cages or bone grafting material to provide stability to the spine.

The biggest drawback of an open surgery is that the pulling apart of muscles damages them as well as the adjoining soft tissues. Hence, there is a greater risk of muscle injury which may increase the healing time. Also, the larger the incision is, the higher is the risk of infection and bleeding.

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Minimally Invasive Spine Surgery (MISS)

This technique was developed in order to reduce the muscle damage caused by the open surgery technique. In this technique helps the surgeon to reach the damaged area with comparatively smaller incision. As the size of the incision decreases so does the bleeding and risk of infections.

Procedure

The most commonly used technique to perform minimally invasive laser spine surgery uses a tubular retractor. The surgeon makes a small incision in the abdomen through which the tubular retractor is inserted down to the spinal column. The tubular retractor creates a tunnel to the area where the problem exists. The surgeon accesses the spine using small instruments that can fit into the retractor. Materials required for the surgery, like screws, are inserted through the retractor. Any material to be removed from the spine is taken out through the retractor. Some of the surgeries may also require more than one retractor and thus more than one incision.With removal of the retractor muscles return to their normal position. Real time x-ray of the patient’s spine helps the surgeon to calculate the position of the incision and retractor. This real time x-ray imaging is known as fluoroscopy.

Types of Minimally Invasive Spine Surgery

Minimally invasive spine surgery may be classified as:

  • Minimally invasive lumbar spine surgery: performed in lower back region.
  • Minimally invasive cervical spine surgery: performed on the neck.
  • Minimally invasive laser spine surgery: in this technique laser is used to treat the patient. This approach can be used for the following:
    Removing tumor from spinal cord
    Removing soft tissues around a nerve
    Shrinking disc material around a nerve

Potential Risks

The biggest risk involved with MISS is inadequate operation. In such a case an additional open surgery may be required.

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