Spine surgery is traditionally done as "open surgery," meaning the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.Because minimally invasive spine surgery (MISS), does not involve a long incision, it avoids significant damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery.
Spine surgery is typically recommended only when a period of nonsurgical treatment — such as medications and physical therapy — has not relieved the painful symptoms caused by your back problem. In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis. Minimally invasive techniques are beginning to be used for a wider range of spine procedures, and have been used for common procedures like decompression and spinal fusion since the 1990s. Decompression relieves pressure put on spinal nerves by removing portions of bone or a herniated disk. Spinal fusion corrects problems with the small bones of the spine (vertebrae). The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. This article focuses on decompression and fusion with a minimally invasive technique.
Minimally Invasive Spine Procedures
There is a rapid increase in technology that allows the MIS physician to treat patients with minimally invasive spine surgery procedures. Some of these techniques are now well established, while others remain new and continue to evolve. The best MIS (Minimally Invasive Spine Surgery) technique will depend on the specific character of the problem. While the list of MIS (Minimally Invasive Spine Surgery) techniques continues to expand, the most commonly employed today include:
- Minimally Invasive Tubular Microdiscetomy
- Minimally Invasive Lumbar Laminectomy
- Cervical laminoforaminotomy
- Endoscopic Discectomy
- Minimally Invasive Transforaminal Interbody Lumbar Fusion (TILF)
- Minimally Invasive eXtreme Lateral Interbody Fusion (XLIF)
- Microsurgical Discectomy
- Posterior Lumbar Interbody Fusion (PLIF)
- Kyphoplasty
- Nucleoplasty or Percutaneous Discectomy
Comparing Minimal type of Invasive pine surgery to Invasive Spine Surgery:
Minimal Invasive Spine surgery comes with more benefice than invasive spine surgery.
- Less scar tissue is created thereby not leaving the patient to recover with huge and ugly scar marks.
- Pain associated with this procedure is effectively less severe as small incisions are made. Also less soft tissues are damaged.
- Less blood is lost and therefore the patients don’t have to be at a medication for long periods of time
- Procedure is more accurate and leaves the patient with better results.
- The cost for such a surgery is quite lesser as compared to an Invasive Spinal surgery.
Candidates
People with back pain, numbness or weakness in upper or lower limbs who are not responding to non surgical treatments like pain killers, non steroidal anti inflammatory drugs and physiotherapy can consider surgery. They need further investigations like X-ray/ CT scan/ MRI to confirm bulging or protruding disc which can be corrected by surgery.
Surgery for herniated disc should be considered emergency if there are symptoms of pressure on the spinal cord or on the cauda equine or cases involving serious or increasing paralysis
Expected Results
The results of herniated disc surgery are good. A successful surgery relieves the symptoms of herniated or slipped disc in up to about 90% of the patients.
Recovery
Recovery is different for each patient. However, it is normal to feel pain at the site of surgery for the first few days which can be controlled with medication. You would be advised to start physical therapy after a week of the surgery for rehabilitation. You would be able to return to normal activities in about two weeks while full recovery may take few weeks to months. Your treating surgeon would advise you about the rehabilitation and when to start rigorous activities.
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