Looking for Minimally Invasive Spine Surgery? 8 Questions to Ask Your Doctor First
Author: Dr. Hamid Abbasi
DATE: 19 Apr 2018
You’ve suffered with chronic neck or back pain for months–maybe even years–and medication and physical therapy haven’t helped. Now your doctor is recommending back surgery. Just the idea can literally send shivers down your spine. Maybe you’ve heard horror stories about spinal surgery gone wrong. Or the long painful road through rehab and recovery. It’s true that traditional open surgeries can do as much damage as good, by cutting through muscle, and sometimes bone, to reach your spine. But there are also new standards of minimally invasive surgical care that are faster and easier and will have you back on your feet in no time. So, it’s important to know your options.
“Open” vs. minimally invasive spinal surgery
Let’s start by understanding where those horror stories come from:
“Open” surgery means cutting an opening in your body and pulling muscle and soft tissue back with retractors, until the surgeon has a direct open view of the spine. In a traditional lumbar fusion, for instance, this could mean a 6” to 7” incision in both the front and back of your body, and a lot of maneuvering around abdominal organs as well as back muscles. The resulting damage to normal, healthy supporting structures gives you and your body lots of extra recovery work to do.
In contrast, there’s minimally invasive spine surgery:
In true minimally invasive surgery (MIS), there’s no need to make an incision right down to your spine in order to see it. Instead, the surgeon relies on an external imaging system or computer-assisted technology to guide the procedure—in what’s known as indirect visualization. The incision is just large enough to insert highly specialized instruments to repair the spine. These can include lasers, endoscopes, or microscopes. The smaller incision minimizes the damage to surrounding muscles and ligaments. It also means less scarring.
Inspired Spine surgeons offer a number of different minimally invasive surgical solutions using their unique “keyhole” technique. Keyhole surgery is pretty much what it sounds like. The surgeon performs the procedure through a tiny keyhole-sized portal—one that is smaller than a dime—where long, thin surgical instruments are inserted through a hollow sheath that protects back muscles and surrounding tissue. Only Inspired Spine surgeons offer this groundbreaking surgical technique.
But wait—aren’t some minimally invasive back surgeries “open”, too
Confused? Don’t worry, so are lots of other back pain sufferers. Here’s why:
Many traditionally trained spine surgeons are reluctant to give up direct visualization. Instead, they favor procedures that use a smaller incision (say 3” instead of 6” long), but still open the spine to direct view. While technically, this is somewhat less invasive than traditional open surgery, it’s still damaging to muscles and other natural healthy structures of the back. While it should be called “mini-access” or “mini-open”, this type of surgery is often labeled MIS or minimally invasive. It’s best to get all the facts before you agree to any spine surgery.
What some so-called MIS surgeries look like
Understanding your spine surgery options: what to ask your doctor
Back surgery is a big decision. It’s important to have as much information as possible. Ask your doctor these questions:
- Which surgical technique do you recommend for me? Why?
- Is this a minimally invasive spine surgery?
- What is the length of the incision? Does it involve direct visualization? Does it use retractors? (If direct visualization and retractors are used, it’s likely a “mini-open” procedure.)
- What is the success rate for this type of surgery?
- What are the risks and possible complications?
- How long will I be hospitalized?
- How long is the recovery period?
- When can I expect to return to a normal lifestyle?
If you’re uncomfortable with any of your doctor’s answers, get a second opinion. It is definitely worthwhile to find the least invasive procedure possible to treat your back problem.
The benefits of minimally invasive spine surgery
MIS doesn’t disturb surrounding muscles and soft tissue the way that open surgery does, which means you’ll have post-operative pain and you’ll get better faster. In fact, many patients can go home on the same day. At most, they spend only a day or two in the hospital. Most patients who undergo traditional open surgery are hospitalized for 3 to 5 days.1 Recovery time is faster, too. In most cases, patients return to work in a few days—much quicker than after other types of surgery.
Less risk, better quality of life for chronic back pain sufferers
The surgeons at Inspired Spine are experts in minimally invasive keyhole spinal surgery and offer patients several types of procedures, including:
- Oblique lateral lumbar interbody fusion (OLLIF)—This keyhole surgery allows Inspired Spine surgeons to fuse the lumbar vertebrae through a tiny, ½-inch incision. it can be used to treat a wide range of low-back pain conditions, including spinal stenosis, scoliosis, spondylolisthesis, herniated discs, and degenerative disc disease.
- MIS Direct lateral interbody fusion (MIS-DLIF)—One of several procedures developed by Inspired Spine, it is a keyhole technique that enables spinal fusion in hard-to-reach areas, such as the space between the bottom of the spine and the sacrum (L5-S1).
- MIS Direct thoracic interbody fusion (MIS-DTIF)—Appropriate for treating causes of mid-back pain. The MIS-DTIF allows for spinal fusion to be performed along the thoracic vertebrae, without a surgical incision into the chest wall) and without removing any ribs, which is a major advantage.
By reducing the risks and damage of surgery, these keyhole procedures can get you back to a normal life easier and faster
If you are considering spinal surgery, make sure you understand all of your options. And watch this blog for future posts. There’s more important information to come.