Spine surgery has been traditionally done as ‘open surgery’, but over the last 30 years or so, minimally invasive spine surgery techniques have been evolving and can now be used to repair a variety of spine disorders including deformities, injuries, herniated discs and degenerative disc diseases of the neck and back.
In contrast to the 5-6 inches long incision made during open surgery, minimally invasive spine surgery (MISS) requires much smaller incisions where only the afflicted area is visible to the surgeon. This results in shorter hospital stays, faster healing time, lesser pain, lesser blood loss and a lower risk for infections as compared to open surgeries. The patient can also get back to their normal routine within a shorter period of time. And all this is because in MISS, there is lower damage to muscles and soft tissues, and lower chances of complications arising from the surgery. In most cases, patients can even go home the same day or in a day or two.
Just like traditional open-back surgery, MISS is only recommended when non-surgical therapies have failed to bring about improvement. It’s also carried out when the surgeon can pinpoint the exact cause of the problem. MISS can be used for a number of surgical procedures including lumbar decompression and spinal fusion.
Procedures such as discectomies and laminectomies can be performed using different approaches, when using minimally invasive surgical techniques. During ‘keyhole’ or MISS surgeries, the most commonly used instrument is the tubular retractor. During the procedure, a small incision is made and the retractor is inserted in up to the required depth where the problem exists. This is done under the guidance of a fluoroscope which displays real-time x-ray images of the spine on a screen. The retractor holds the muscles in place rather than cutting them and also creates a tunnel through which the surgeon can pass in instruments and remove out damaged tissue. The tubular retractor tunnel is also sufficient to pass in screws and rods needed for fusion surgeries.
In some cases, more than one retractor is required meaning two small incisions. Surgeons are increasingly performing endoscopy-guided surgeries wherein a camera is also passed down the retractor, thus giving exact views of the affected areas.
At the end of the procedure, the retractor is withdrawn and the muscles go back to their normal positions with minimal damage. Types of anesthesia used could be general or regional.
The Sita Bhateja Specialty Hospital in Bangalore has a formidable team of experienced surgeons specialized in the use of this highly-intricate minimally invasive spine surgery. And when backed by a world-class operating theatre complex, an up-to-date ICU and a physiotherapy and rehabilitation center, the patients here are in the best hands possible.