Minimally invasive surgery (MIS) procedures are performed through one or more short incisions, making them a superior option for almost anyone who requires surgical repair. Minimally invasive surgery involves significantly less postoperative pain, a shorter hospital stay, faster recovery and, in some cases, a better overall outcome.
In general, the goal of minimally invasive spine surgery is to stabilize the vertebral bones and spinal joints and/or relieve pressure being applied to the spinal nerves. As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. Because of the reduced trauma to the muscles and soft tissues (compared to open procedures), some potential benefits are faster recovery time, less rehabilitation afterwards, less blood loss from surgery, and diminished reliance on pain medications after surgery.
Dr. Eric Wieser and Texas Comprehensive Spine Center offer a variety of minimally invasive techniques. These can resolve problems such as herniated, bulging or degenerative disc; arthritis (spine) and bone spurs; facet disease; pinched nerves; spinal stenosis.
How Minimally Invasive Spine Surgery Works
Because the spinal nerves, vertebrae and discs are located deep inside the body, any approach to gain access to the spinal area requires moving the muscle tissue out of the way. In general, this is facilitated by utilizing a small incision(s) and guiding instruments and/or microscopic video cameras through these incisions.
A number of methods can be used to minimize trauma during MIS surgery. Some of the more common techniques include using a tubular retractor. This technique involves progressive dilation of the soft tissues, as opposed to cutting directly through the muscles. By using tubes to keep the muscles out of the way, the surgeon works through the incision without having to expose the area widely. Once the procedure is complete, the tubular retractor can be removed, allowing the dilated tissues to come back together. Depending on the extent and type of surgery necessary, incisions can often be small.
Percutaneous Placement of Screws and Rods
Depending on the condition of the patient, it may be necessary to place instrumentation, such as rods and screws, to stabilize the spine or to immobilize the spine to facilitate fusion of the spinal bones. Traditional approaches for placement of screws requires extensive removal of muscle and other tissues from the surface of the spine.
However, percutaneous (meaning “through the skin”) placement typically involves inserting rods and screws through relatively small skin incisions without cutting or dissecting the underlying muscle. With the aid of x-ray images, guidewires are placed through the skin and into the spinal vertebrae along the desired paths for the screws. Then, screws are placed over the guidewires and follow the path of the wires. These screws have temporary extenders that extend outside of the skin and are subsequently removed after helping to guide passage of rods to connect and secure the screws. With the use of spinal navigation and robots, spinal instrumentation is being placed more safely and accurately.
Direct Lateral Access Routes
In some cases, especially those involving the lumbar spine, approaching the spine from the side of the body results in reduced pain, due to the limited amount of muscle tissue blocking the way. This approach is typically performed with the patient on his or her side. Then, a tubular retractor docks on the side of the spine to enable access to the spine’s discs and bones.
Thoracoscopic Access Route
Depending on the patient's condition, it may be necessary to access the front portions of the thoracic spine, located in the chest and surrounded by the heart and lungs. Traditional access approaches often involve opening the chest through large incisions that may also require removal of one or more ribs. However, thoracoscopic access relies on multiple small incisions, through which working ports and cameras can be inserted to facilitate surgery.
Common Symptoms Seen Through Minimally Invasive Spine Surgery
If you suffer from chronic back pain and medications, therapy and injections have not aided you in the past, spine surgery may be an option for you. Our comprehensive team of spine care surgeons and staff will determine whether or not MIS may be right for you. While spine surgery can’t fix all types of back problems, if you have condition listed below, MIS may help. This includes conditions such as:
- Herniated disc
- Spinal stenosis (narrowing of the spinal canal)
- Spinal deformities (like scoliosis)
- Spinal instability
- Spondylolysis (a defect in a part of lower vertebrae)
- Fractured vertebra
- Removal of a tumor in the spine
- Infection in the spine
If you think MIS may be the solution to your back pain, schedule an appointment with our spine experts to discuss the right option for you. Call us at (817) 261-8272 or click here to fill out a form online.