Minimally invasive sounds good, but what does it really mean for spine surgery?
Surgery, by definition, is invasive. Surgeons open up the body to see and work on a damaged or diseased area inside. Sort of like “getting under the hood” of your car to fix the engine, but using a blowtorch to do it. The engine may be fixed, but imagine the body work needed to repair the exterior damage! Some treatments are more invasive than others. In open heart surgery or total hip replacement, for example, the bodily damage created by the procedure is often the most painful and long-lasting aspect of the recovery process. Spine surgery – particularly spinal fusion – has long been in that category. In contrast, non-invasive treatments do not require an incision or removal of any tissue.1
Advances in surgical technology strive to minimize the damage
About 30 years ago medical experts started to think about improving the cost-benefit ratio of surgery for patients by reducing incision size and the damage it can cause. The field of minimally invasive surgery (MIS) was born.2
Since then, MIS science has advanced from endoscopy (literally endo- “inside” and -scope “look”) and laparoscopy to fully robotic remote-controlled techniques. Instruments inserted through small cuts or natural body openings (such as the esophagus) allow surgeons to visualize and treat many kinds of problems from outside the body.
Today, MIS or keyhole surgery is routine in many non-spinal procedures, ranging from cardiology to orthopedics. Because the wound is tiny, patients have less pain. They get better faster. And they and go home sooner. They also experience fewer risks from surgery.
MIS of the spine is often MIS-labeled open surgery
For one reason or another – because the spine is integrated into the core structure of your body… because it has no natural openings or body cavities… because neurosurgeons are reluctant to give up direct visualization of their work… MIS techniques for the spine have not kept pace with the rest of medical technology.
As a result, MIS of the spine is often MIS-applied to open surgery techniques with slightly smaller incisions. This is particularly true of spinal fusion surgery.
Here’s what many so-called MIS fusion surgeries look like
1. The surgeon makes a 3” incision (instead of a 6” cut)
2. Retractors pull back muscle and soft tissue to expose the spine
Although the incision is smaller, the overall effect is similar to open surgery:
- Healthy muscle and natural supporting structures are still cut away from the spine. This damage cannot be undone. Only scar tissue will form.
- There is significant blood loss, increasing the risk of surgery.
- Because the surgeon is trying to maneuver through a smaller opening, the surgery may actually take as long or longer than traditional open surgery. This too, increases patient risk.
- It’s virtually impossible to use mini-access (or mini-open) techniques like this on obese patients. This excludes a large contingent of back pain sufferers.
Some less invasive spinal fusion methods, such as the XLIF, use several smaller incisions (as opposed to a single large incision) and don’t actually cut muscle. Instead, they split the muscle fibers with retractors in order to view the spine. Nevertheless, it can still take as long as a few months for patients to be able to return to their normal activities.3
Now compare Keyhole Spine Surgery
Inspired Spine is advancing the science of MIS spine surgery by 20 years with our unique keyhole approach. The surgery is performed through a small portal (just 10 millimeters or smaller than a dime), that avoids cutting, disrupting or damaging back muscles and ligament structures.
Instead of direct visualization of the spine, our unique approach uses fluoroscopic imaging to guide the procedure.
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Our signature keyhole spinal fusions are the only truly minimally invasive fusion surgeries available today. The surgeon removes the diseased disc, restores the height of the disc space, and inserts bone graft material–all through a dime-sized portal. Even multiple levels of the spine can be treated from a single portal.
Major muscles and natural, healthy structures in the back are preserved, promoting faster recovery. Unlike other spinal fusions, many patients are able to get up, walk around, and return home within a few hours after surgery. And you can expect to recover in weeks, not months.