For many patients in need of spine surgery, minimally-invasive techniques have replaced traditional methods. These new procedures offer benefits like smaller incisions, less discomfort and shorter recovery times in many cases. The operations also result in less damage to surrounding muscle and other non-damaged structure, reducing the risk for complications and significant post-operative pain. Because incision size is substantially reduced, scarring after surgery is also minimal for a more pleasing cosmetic result.
Minimally-invasive spine surgery uses special instruments and tools that create the same outcome as traditional surgery, but with less collateral damage to surrounding tissue and muscles. The most common approach to minimally-invasive operations involves a tubular retractor, which is inserted through a tiny incision. The retractor is carefully guided to the area of the spine in need of repair, moving muscle to make way for the retractor instead of cutting it for access.
Fluoroscopy is used to visualize the path of the retractor, which displays a real-time x-ray image for the surgeon to “see” the location of the surgery. Instruments are inserted through the retractor to remove pieces of bone and herniated disc while placing screws or other devices required to stabilize the spine in the damaged area. Once the corrections are completed, the retractor is removed, and the incision is stitched closed.
Most minimally-invasive spine surgeries are performed using general or regional anesthesia. In some cases, patients can go home a few hours later. Other patients may need to spend a day or two in the hospital, but hospital stays are significantly reduced when these methods are employed.
While minimally-invasive spine surgery offers a host of benefits, it is not the right approach for everyone. Patients that will require more complex repair or multiple areas of correction will likely still need open surgery to achieve an optimal outcome. Your physician will probably not recommend even minimally-invasive surgery until conservative treatments like medication or physical therapy have been tried and been shown to be ineffective. It is essential for patients to understand that while a surgeon may start performing a procedure using less invasive techniques, there is a possibility that open surgery will be needed to complete the operation correctly.
Some treatments lend themselves better to minimally-invasive techniques than others. Those include:
Spinal Decompression
This treatment is used to relieve the symptoms of spinal stenosis or narrowing of the spinal canal. The aim of the surgery is to reduce compression on the nerves to eliminate pain, numbness or tingling that commonly accompanies this condition. In some cases, the retractor can be used to remove soft tissue and bone fragments that are causing the pressure.
Spinal Fusion
During this surgery, vertebrae are fused together to create stability in the spine after fractures, recurrent herniated discs or spondylolisthesis. The procedure can be performed using a retractor to place bone fragments or synthetic material onto the vertebrae and to insert the metal screws or plates that will hold them in place.
Discectomy
Removal of a herniated disc can also be handled through less invasive methods if the surgeon is only removing a portion of a single disc during the procedure. In some cases, the entire disc may even be removed via a retractor. The removal of the damaged disc eases pressure on the nerves of the spine to relieve back pain and pain and tingling in the legs as well.
While there will be some recovery time after minimally-invasive spine surgery, it is generally much less than what patients experience after traditional open surgery. Some operations may be done on an outpatient basis. If you do need to spend some time in the hospital, it will likely be for one or two days, rather than the standard three to five days required with traditional procedures. You should expect to have some discomfort, but patients that undergo less invasive surgery tend to be able to manage their pain more effectively with medication. Depending on the procedure you have, you should be able to return to your daily activities within a few weeks.
When appropriate, minimally-invasive spine surgery is a preferred method of correcting a variety of painful conditions. Our team at the Orthopaedic Institute of Ohio is well-versed in these techniques and will ensure you achieve optimal results from your procedure. To learn more about your choices in spine surgery, contact the Orthopaedic Institute of Ohio today at 419-222-6622.