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• Minimally Invasive Spine Surgery
• Types of minimally invasive spine surgery
• Spinal conditions treatable with minimally invasive surgery
• Risks of open and MIS spine surgery
• Benefits of minimally invasive spine surgery
• Procedure

Minimally Invasive Spine Surgery (MIS)

Minimally invasive spine surgery is a newer method of performing spine surgery. Usually, a single long incision is made in traditional spine surgery to make the surgical site visible by retracting a large area of muscles and tissues, causing more tissue damage, and patients experience more postoperative pain.

In minimally invasive surgery, surgeons make one or more tiny incisions of half an inch. These small incisions create entry sites for surgical instruments and an endoscope. Your doctor will work through these small incisions, causing less muscle and tissue damage, less postoperative pain, shorter hospital stay, and quicker recovery.

Types of minimally invasive spine surgery

• Endoscopic spine surgery
• Robotic-assisted spinal surgery can enhance surgical precision and reduce human errors.
• Artificial intelligence can help predict which type of surgery is likely most successful. 

Spinal conditions treatable with minimally invasive surgery 

• Lumbar disc herniation
• Spinal infection
• Spinal fusion
• Lumbar spinal stenosis
• Spinal tumor decompression
• Scoliosis and kyphosis
• Vertebral compression fractures

Candidates for minimally invasive surgery

Your doctor will evaluate your symptoms and condition and may provide other non-surgical treatments before considering surgery. Not everyone is a suitable candidate for minimally invasive surgery. 

Risks of open and MIS spine surgery

Common risks of spine surgery are: 

• Bad reaction to the anesthetics.
• Postoperative pneumonia. 
• Pulmonary emboli.
• Surgical site infection.
• Perioperative blood loss.

Specific risks of spine surgery include:

• Spinal fluid leak. 
• Surrounding tissue damage
• Spinal cord or nerve injuries causing pain or paralysis, the risk of paralysis is 1 in 10,000 for major spinal reconstructive surgery.

Benefits of minimally invasive spine surgery

Minimally invasive spine surgery has many benefits over open surgery, including: 

• Require less anesthesia.
• Minimize operative blood loss.
• Cause less muscle and soft tissue damage. 
• Lower the risk of infection. 
• Result in less postoperative pain
• Decrease the use of pain relievers.
• Leave shorter operative scars.
• Need less postoperative hospital stay.
• Promote faster recovery and quick return to the daily routine. 

Procedure

Before the procedure

You should stop smoking and exercise regularly to strengthen your muscles for faster recovery. Inform your doctor if you are on certain medications to evaluate if you need to stop taking them to avoid bad reactions to anesthetic drugs. 

The doctor will obtain X-rays or magnetic resonance imaging (MRI) tests of your spine. You will receive antibiotics before the surgery to prevent infection. Check with your doctor if there is a food and drink restriction before the surgery.

During the procedure

Minimally invasive spine surgery is performed under either regional or general anesthesia. One or more tiny incisions will be made through your chest, back, or abdomen.

A fluoroscope, which can provide real-time images of your spine during the surgery, will be used to determine the site of incisions. An endoscope is a thin, tube-like instrument with a tiny video camera on its tips that projects the internal view of your spine on a screen. Tubular retractors create small tunnels from the incision to the surgical area on your spine. These tunnels serve as a surgical workspace for inserting surgical instruments or removing spinal bone or tissue. Your incisions will be closed with sutures, staples, adhesive strips, or glue.

After the procedure

Usually, you need to stay in a hospital for 3-5 days. The total recovery period depends on your age, health, spinal problem, surgical difficulty, and the skill and expertise of the surgical team. In some patients, the complete recovery can take several months. Physical therapy can help strengthen your muscles and speed up your recovery.

However, you should contact your doctor right away if you start to develop the following symptoms:

• Fever over 38 degrees Celsius.
• Aggravated pain.
• A large amount of fluid leakage from the incision (a small amount is usual).

Immediately go to the emergency department if you have difficulty breathing or a severe headache.

Before having minimally invasive spine surgery, you should research and consider a skilled and experienced multidisciplinary spine team, including orthopedic surgeons, physical medicine and rehabilitation physicians, neurologists, and pain psychologists. Ask for the number of spine surgeries they have performed and the surgical outcome.