Minimally Invasive Spine Surgery Fundamentals
Minimally invasive spine surgery is an endoscopic procedure that uses specialized video cameras and instruments that are passed through small incisions (less than 2 cm) in the back, chest or abdomen to access the spine and perform the needed surgery.
Endoscopic techniques have been used for several decades, but for diagnostic purposes only. In the late 1970s and early 1980s, endoscopic techniques were advanced so that both a diagnosis could be made and the disease could be treated. These same endoscopic techniques used in other surgical disciplines have now been advanced to the treatment of spine disorders.
Not every patient, however, is a candidate for a minimally invasive approach to spine surgery. To see if you are a candidate for this approach for spinal tumors, deformity, trauma, or degenerative disease you must be fully evaluated by a surgeon knowledgeable and experienced in these minimally invasive techniques. The spine surgeons at Cleveland Clinic are leaders in the field and have been instrumental in advancing these techniques.
Minimally invasive spine surgery: What are suitable conditions?
In certain cases of degenerative discs, scoliosis, kyphosis, spinal column tumors, infection, fractures and herniated discs, minimally invasive techniques may speed recovery, minimize post-operative pain and improve the final outcome. Many types of minimally invasive spine surgery are performed at Cleveland Clinic including:
- Spinal fusion, which is often performed on degenerative disks
- Deformity corrections, such as for scoliosis
- Repair of herniated disks
- Decompression of spinal tumors
- Repair and stabilization of vertebral compression fractures
What are the benefits of minimally invasive spine surgery?
Minimally invasive spine surgery offers several advantages over open surgery, which typically requires large incisions, muscle stripping, more anesthesia, a long hospital stay, and a long recuperation period. The benefits of spine surgery include:
- A few tiny scars instead of one large scar
- Shorter hospital stay – a few days instead of a week
- Reduced postoperative pain
- Shorter recovery time – a few months instead of a year – and quicker return to daily activities, including work
- Less blood loss during surgery
- Reduced risk of infection
What are the risks of spine surgery? Is the surgery safe?
As with any surgical procedure, including minimally invasive spine surgery, there are general risks and procedure-specific risks. The more common general risks of spine surgery include the risk of adverse reactions to the anesthetic, post-operative pneumonia, blood clots in the legs (deep vein thrombosis) that may travel to the lungs (pulmonary embolus), infection at the site of surgery and blood loss during surgery requiring a transfusion. The specific risks of spine surgery include the risk of injury to the nerves or spinal cord resulting in pain or even paralysis, (the estimated risk of paralysis for major spinal reconstructions is somewhere around 1 in 10,000), the instrumentation, if used, breaking, dislodging or irritating the surrounding tissues, and pain from the surgery itself. On rare occasions, during a minimally invasive procedure, the planned surgery cannot be completed and requires either a second trip to the operating room or a conversion from the minimally invasive technique to a full open technique.
How do I prepare for spine surgery?
To prepare for spine surgery, quit smoking if you smoke, exercise on a regular basis to improve your recovery rate, stop taking any non-essential medications and any herbal remedies which may react with anesthetics or other medications and ask your surgeon all the questions you may have.
What happens during minimally invasive spine surgery?
Most types of minimally invasive surgery rely on a thin telescope-like instrument, called an endoscope, or on a portable X-ray machine, called a fluoroscope, to guide the surgeon while he or she is working. The endoscope is inserted through small incisions in the body. The endoscope is attached to a tiny video camera – smaller than a dime – which projects an internal view of the patient’s body onto television screens in the operating room. Small surgical instruments are passed through one or more half-inch incisions, which are later closed with sutures and covered with surgical tape. The fluoroscope is positioned around the patient to give the surgeon the best X-ray views from which to see the anatomy of the spine.
What are the CCF physician credentials?
All doctors at Cleveland Clinic Center for Spine Health are fellowship-trained and board-certified or board-eligible in orthopaedic surgery, medical spine or neurosurgery. In addition, our surgeons have subspecialty training and years of experience in spine surgery.
All Cleveland Clinic staff radiologists are board-certified or board-eligible in radiology or have the international equivalent.
All Cleveland Clinic staff rehabilitation specialists are board-certified or board-eligible in physical medicine and rehabilitation, or have the international equivalent.
All Cleveland Clinic staff pain management specialists are board-certified or board-eligible in pain management or have the international equivalent.
How do I make an appointment?
Call 216.444.BACK (2225) or toll free 800.223.2273, ext. 4-2225, Monday through Friday, 8:00 a.m. to 5:00 p.m. (Eastern Standard Time).
What clinical trials and orthopaedic research are being conducted at CCF for spine conditions?
Researchers at Cleveland Clinic are involved in ongoing studies that investigate new drugs and treatment approaches for managing disease. Participants in these clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. There are currently more than 1,700 active clinical studies underway.
Are there other resources that I can go to for more information on minimally invasive spine surgery?
Patients can go to the following resources for more information on this procedure:
- Cleveland Clinic Health Information Center
- American Academy of Orthopaedic Surgeons
- North American Spine Society
- Scoliosis Research Society
- Spine Universe Website
Why should I seek a second opinion regarding treatment for this procedure?
As modern medical care grows more complex, patients can feel overwhelmed. The opportunity to consult a recognized authority about a particular diagnosis and treatment can bring peace of mind at an emotionally difficult time. A second opinion may be beneficial when:
- You are uncertain about having surgery.
- You still have questions or concerns about your current treatment.
- A controversial or experimental treatment is recommended.
- You have multiple medical problems.
- You have choices to make about treatment.
A convenient way to obtain a second opinion is e-Cleveland Clinic, a contemporary adaptation of The Cleveland Clinic’s 80-year tradition as a nationally designated referral center. An easy-to-use, secure, from-home second opinion service, e-Cleveland Clinic utilizes sophisticated Internet technology to make the skills of some of our specialists available to patients and their physicians, anytime, anywhere. With e-Cleveland Clinic’s personalized access, no patient need ever to feel unsure or uninformed when faced with what could potentially be one of the most important decisions of their life. Learn more about e-Cleveland Clinic.