Minimally Invasive Spine Surgery

What is minimally invasive spine surgery?

Minimally invasive spine surgery is a procedure to access your spine using methods that are less disruptive to nearby muscles and tissue.

In a traditional open surgery approach, your surgeon makes a single, long incision through your skin. To help your surgeon clearly see the surgical site, a relatively large amount of muscle and surrounding soft tissue are pulled away from the bone. This can result in a longer healing time and more pain after surgery.

In minimally invasive surgery, your surgeon makes one or more incisions through your skin. A small metal tube or endoscope passes through the incision to allow your surgeon to work through a smaller operating field. This results in much less damage to your muscles, soft tissues and skin. Your healing time is usually shorter with this procedure.

What are the different types of minimally invasive spine surgery?

Many types of spine surgeries can use a minimally invasive approach. Common types include:

• Spinal decompression.
• Diskectomy.
• Spinal fusion/fixation.

What does minimally invasive spine surgery treat?

Minimally invasive spine surgery can treat or manage the following conditions:

• Cervical spondylosis.
• Degenerative or “slipped” disks.
• Herniated disk.
• Instability.
• Kyphosis.
• Scoliosis.
• Spinal stenosis.
• Spinal tumors.
• Vertebral compression fractures.

Who is a good candidate for minimally invasive spine surgery?

A surgeon will determine if you’re a good candidate for minimally invasive spine surgery. They’ll review several factors — most importantly, your spine must be accessible through small surgical corridors.

Surgery is usually an option if other forms of treatment, like medications or physical therapy, haven’t been successful in relieving symptoms.

Your surgeon may consider a minimally invasive approach if they can pinpoint the exact location of the cause of your symptoms. This reduces the need to open up your spine to try to locate the problem.

How should I prepare for minimally invasive spine surgery?

Before minimally invasive spine surgery, you’ll meet with your surgeon for a consultation. They’ll perform a physical exam and order imaging tests to plan for the procedure.

Your surgeon will give you specific instructions to follow before surgery, which may include:

• Undergo additional tests, like an X-ray, computed tomography (CT) or magnetic resonance imaging (MRI) test of your spine.
• Stop smoking if you smoke.
• Get regular physical activity before your surgery to keep your body and muscles in shape and shorten your recovery time.
• Stop taking or start taking certain medications before surgery. This may include taking antibiotics or stopping any non-essential medications or supplements that may interfere with your healing. Don’t stop taking medications unless a provider approves it. Lastly, you should always try to hold off on opioids until after your surgery.
• Follow instructions on what you can eat or drink the night before surgery.
• Ask someone to drive you to and from the procedure and help you out at home for the first few days during your recovery.

What happens during minimally invasive spine surgery?

On the day of your surgery, an anesthesiologist will give you anesthesia. Depending on what type of minimally invasive spine surgery you need, you may get local anesthesia, which numbs an area of your spine, so you’ll be awake but won’t feel pain. Or you may be put to sleep with general anesthesia, so you won’t feel any pain.

During minimally invasive spine surgery, your surgeon will:

1. Make an incision(s) (cut) in your skin through your back, chest or abdomen.
2. Insert a tube and operate under microscope visualization. Alternatively, your surgeon will insert a stick-like device with a camera on the end (endoscope) to see the operating area.
3. Use small surgical instruments to complete the procedure through the endoscope tube or through the other incisions with thin, hollow tubes (tubular retractors).
4. Remove retractors and devices so your muscles and tissue return to their original position.
5. Close the incision site(s) and cover them with bandages.

Do surgeons use robotics during minimally invasive spine surgery?

Yes, certain surgeons and hospital systems rely on robotics to effectively perform minimally invasive spine fusions. Robotics in medicine aren’t sci-fi characters; rather, they’re tools to help surgeons perform complex procedures that require more precision than traditional surgical techniques offer. Your surgeon will let you know if they’ll be using robotic surgery during your procedure.

How long is minimally invasive spine surgery?

Your surgeon will explain how long they expect surgery to take for your situation. It could take less than an hour or a few hours to complete based on the type of minimally invasive spine surgery you’re having.

What happens after minimally invasive spine surgery?

After minimally invasive spine surgery, you’ll move to a recovery area of the hospital while your anesthetic wears off. If you had general anesthesia, you’ll feel groggy when you wake up.

Some procedures allow you to go home the same day as your surgery so you can recover in the comfort of your own home. You may need to stay in the hospital overnight or for a couple of days depending on what your surgeon needed to do.

You’ll likely experience some discomfort after minimally invasive surgery, but it’ll be less intense than undergoing open surgery. This is because the minimally invasive techniques limit damage to your muscles or tissues. To manage your pain, your provider may recommend pain relievers.

You’ll also leave the surgery with instructions on how you can take care of yourself during your recovery. This includes incision site care, what activities are safe to do and guidance for follow-up appointments.

What are the benefits of minimally invasive spine surgery?

The benefits of minimally invasive spine surgery include:

• Shorter procedure and recovery time.
• Less pain after surgery due to limited muscle and tissue damage.
• A few or one scar(s) instead of one large one.
• Reduced risk of infection.
• Decreased blood loss in the operating room.

This type of surgery allows you to get back on your feet faster than traditional surgery, so you don’t need to take a lot of time off of work or school before you feel better.

What is the success rate of minimally invasive spine surgery?

Minimally invasive spine surgery has a positive success rate as long as you have the appropriate expectations. The exact rate varies based on the technique your surgeon uses. The success rate for minimally invasive spine surgery is measured by reducing symptoms like pain by managing the underlying cause. Talk to your surgeon to learn more about your expected outcome.

What is the downside of minimally invasive spine surgery?

All surgeries have risks, even minimally invasive procedures. Common risks of minimally invasive spine surgery include:

• Bleeding.
• Blood clots.
• Infection.
• Nerve damage.
• No symptom relief.
• Pain.
• Bones don’t fuse as expected (pseudoarthrosis).
• Misplacement of instrumentation.
• Reaction to anesthesia.
• Tissue damage.
• Spinal fluid leak.

On rare occasions, minimally invasive surgery may not go as planned. You might need a second surgery or your surgeon might need to change the technique from minimally invasive to an open surgery.

Minimally invasive spine surgery scarring

You can expect to have one or more scars after minimally invasive spine surgery. The location of the incision site, and ultimately the scar, varies based on the reason for the procedure. You’ll also receive instructions after surgery on how you can take care of your incision site(s) to reduce scarring.

What is the recovery time for minimally invasive spinal surgery?

The total time to fully recover after minimally invasive spine surgery depends on the cause of symptoms, the degree of difficulty of your procedure, your age, your general health and other factors. It could take weeks to months. Your surgeon will give you the best time estimate for your situation.

What can I expect during recovery after minimally invasive spine surgery?

During your recovery, you’ll need to rest and relax to let your body heal. This can be difficult to do if you live an active lifestyle. Avoid strenuous activities and heavy lifting for several weeks following surgery. You may need to ask someone to help you out around your home for a few days to weeks while you rest.

Your provider might recommend physical therapy to help you regain strength and speed up your recovery.

Make sure you keep all follow-up appointments with your care team. They’ll check your progress and answer any questions or concerns you may have.

When should I call my healthcare provider?

Contact your surgeon if you notice any of the following after surgery:

• Bleeding from the incision site.
• A fever.
• Severe pain.
• Swelling.

Call 911, your local emergency services number or go to the emergency room if you:

• Have trouble breathing.
• Have a severe headache.

What factors do I need to consider when looking for medical help for my spine problem?

To achieve the best outcome for your spine or back pain problem, it’s important to do some research and find a spine treatment center that offers a team approach. Surgeons need to be highly knowledgeable, skilled and have a lot of experience in using minimally invasive techniques. Surgeons shouldn’t be the only team members, however. A good spine health team will include physical medicine and rehabilitation physicians, interventionalists (to address both the mental and physical aspects of your spine problem), general neurologists and pain psychologists, as well as a diverse surgical team.

Never hesitate to ask many questions about a step-wise plan for your spinal health and, if surgery is needed, don’t hesitate to ask about the number of surgeries the team has performed and their outcomes.

What are some of the latest exciting advances in minimally invasive spine surgery?

Some of the biggest advances in minimally invasive spine surgery include:

• Endoscopic spine surgery: Surgeons now have better visibility, light and 3D depth perception due to the improvements made in endoscopes (thin tubes with camera lenses and light sources). Also, a larger variety of tools can be inserted through an endoscope, allowing the minimally invasive approach to be an option for more types of surgeries and patients. Spinal fusions, as well as decompressions, can be performed with an endoscopic approach.
• Robotic-assisted spinal surgery: Surgeons can plan access to the spine by using a computer-guided surgical robot. Gaining access to the spine using robotic technology helps make the surgery safer and the placement of spinal hardware more accurate.
• Artificial intelligence: Surgeons can use the power of computers to review the wealth of available patient data to predict what type of surgery might be most successful for a specific person.