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Minimally Invasive Spine Surgery

Benefits of minimally invasive surgery

Minimally invasive surgery is quickly becoming the method of choice for combating neurological disorders that demand surgical treatment. Typically resulting in less pain, scarring and recovery time than traditional surgery, minimally invasive procedures also generally incur lower heath-care costs.

Also known as minimal access spine surgery and endoscopic surgery, minimally invasive spine surgeries are designed to produce the same results as traditional operations, but are made with smaller incisions and minimal cutting of muscle. Specially designed instruments called tubular retractors pair with endoscopes, or small cameras, are inserted through fingernail-sized incisions allowing surgeons the ability to see the spine with minimal cutting. Minimally invasive surgery often results in fewer post-operative infections and complications, resulting in better long-term results for patients. The surgery is generally performed in a matter of hours, and only in extreme cases require hospital stays of more than a few days.

The goal of minimally invasive spinal surgery is to achieve the clinical outcome of conventional open surgery without the risk of injury and prolonged recovery process. Typically resulting in less scarring and recovery time than traditional open surgery, minimally invasive surgery requires specific and extensive training and skill, but offers the optimum benefit to patients.

The Procedures

Endoscope
The use of an endoscope allows access to the spine while not disturbing adjacent muscle and tissue. In the case above, an endoscope is being used to repair a herniated disc. This procedure leaves a scar less than an inch wide, and some patients can leave the hospital the same day and return to normal activity in a matter of days.

Advancements in medical technology have made minimally invasive surgery possible by providing surgeons the ability to make smaller, more precise cuts and adjustments both inside and outside of the body. Specially designed instruments called tubular retractors pair with endoscopes (small cameras) or microscopes and are inserted through fingernail-sized incisions in the back or abdomen, allowing surgeons the ability to see a patient's arteries, veins, nerves and spine with minimal cutting and little disruption of surrounding organs and tissue.

Back surgery once consisted of making large cuts into the patient's back, severing the muscle supporting the spine and separating it from the spine itself. It was only then that surgeons could address collapsed discs and insert rods and screws. Minimally invasive techniques, however, use either endoscopes or microscopes to view what at one time required major incisions to see with the naked eye.

With endoscopes or microscopes, proficient surgeons can treat small areas of the spine with incisions of only a few centimeters. Small tools are inserted through a tube as surgeons operate from outside the body. This technique reduces not only scarring and recovery, but virtually eliminates danger to the muscles and tissue exposed when the body is sliced open.

Minimally invasive surgery is used to treat disorders of the cervical, thoracic and lumbar spine, including herniated discs without making a large incision in the skin or cutting the muscles that cover the spine. There are many types of procedures used to treat a wide range of spinal disorders.

Kyphoplasty image
Kyphoplasty, is performed by inflating a balloon between vertebrae to create a cavity that is then filled with cement. The procedure, though primarily for pain relief, can restore height and make a patient's life more comfortable.

Compression fractures of the spine often occur in elderly patients and can be treated using minimally invasive surgery. After the initial compression fracture, patients have a 50% chance of having another, which multiplies pain and restricts mobility. This disorder is often treated with Kyphoplasty, which is performed by inflating a balloon between vertebrae to create a cavity that is then filled with cement. The procedure, though primarily for pain relief, can restore the height of the compressed vertebrae and make a patient's life more comfortable.

The endoscopes used today are no larger than a dime and will gradually get smaller and more precise, as will cutting instruments. As medical technology and clinical proficiency continue to advance, minimally invasive surgery will only become more popular and effective.

The Recovery

Because the procedure requires so little disruption of surrounding tissue, patient movement is seldom restricted and recovery time is minimal. Advising a patient to remain in bed for a few days is counterproductive: they need to be walking around, and most begin physical therapy almost immediately. A great benefit of minimally invasive surgery is reduced recovery time and a shorter hospital stay. Less pain, scarring and fewer post-operative infections and complications are all advantages of the technique, which also reduces the need for a blood transfusion during the surgery. This, combined with better long-term results for patients, is a major reason for the procedure's popularity.

Minimally invasive procedures are fast becoming the preferred method of treating the most common spinal pathology. As a result, more surgeons are looking at patients differently, finding ways to perform customary surgeries pain-free and with minimal disruption to the body. With further research and developmental technologies, minimally invasive procedures can become the norm, resulting in a better quality of life for patients.


 

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