Minimally Invasive Spine Treatment

Traditional open spinal surgery requires an incision over the area requiring repair. Typically this requires a significant recovery period, which is often painful for the patient. There is also the risk of muscle damage, increased blood loss, and visible scars.

Minimally invasive spine surgery has emerged as an alternative for some cases of spinal stenosis, and disc herniation, as well as more complex conditions like spine trauma, tumor and deformity.

In addition to replacing traditional open surgical procedures, several new procedures have been developed using exclusively minimally invasive techniques, e.g. Vertebroplasty and Kyphoplasty.

As the name implies, the procedure is less traumatic to the patient. Benefits include:

• Shorter recovery period and shorter hospital stays
• Less pain during recovery
• Reduced blood loss
• Avoidance of muscle damage
• Less noticeable visible scars

All of these open surgical procedures can also be performed with minimally invasive techniques:

• Discectomy
• Posterior Cervical Foraminotomy
• Posterior Lumbar Interbody Fusion (PLIF)
• Transforaminal Lumbar Interbody Fusion (TLIF)
• Spinal Fusion with Bone Morphogenetic Protein

In addition to these more traditional surgeries, Vertebroplasty and Kyphoplasty were originally developed as minimally invasive treatments – in other words, they are not alternative techniques to open surgery.

In Vertebroplasty, polymethylmethacrylate (PMMA), a type of orthopedic cement, is pushed into the vertebral body through a needle. The cement hardens within a few hours, and once it does so, patients can be up and about. This procedure is also useful in strengthening vertebral bodies that are weakened but not yet fractured.

In Kyphoplasty, balloons are used to expand the space where the cement is to be injected. This can help restore height to the spine and reduce deformity.

Minimally Invasive Spine Surgery Basics
The principle of many minimally invasive spine surgeries is the insertion of a small tube into the affected area. Using computer-assisted image guidance, the spine surgeon can then:

• insert a tube straight through skin, fat, and muscle and into bone
• pass screws through
• pass rods through into the heads of the screws and tighten
• perform many other steps through the tube

The endoscope allows the surgeon to have an illuminated and magnified view of the operating field without having to make a large incision. With the assistance of the endoscope surgeons can utilize several small incisions to perform the same procedure they would otherwise perform using a single large incision.