If you have severe back pain, you might think a big open-spine surgery with a long recovery time is your only option for permanent relief. These days, however, some operations are minimally invasive and require much shorter recovery time. Not all back problems are suitable, but for those who are, patients are thrilled to shorten pain and recovery time.
How much smaller is the incision?
The term minimally invasive means that the orthopedic surgeon accomplishes spinal correction by only accessing what is required. They use several tiny incisions, so there is less damage to ligaments and muscles surrounding the spine. Most of that tissue is left alone. Rather than a vertical incision along the spinal vertebrae, several small incisions give adequate access to repair the damage.
These are very like the smaller incisions now used in the abdomen to remove gallbladders, repair hernias, and much more. Minimally invasive procedures, using tiny instruments to view and access the surgical field, are more common than ever.
What’s the advantage?
There are several good reasons why surgeons opt for minimally invasive surgery (MIS) when they can. For you, the benefits are excellent.
- The incisions are much smaller, as little as two centimeters, about a ¾ inch.
- You recover much faster.
- There is a smaller risk of infection.
- You will have less tissue damage. Muscle and tendons are usually spared completely.
- Some surgeries may be so minimal that no general anesthetic is needed, making the surgery safer and easier to recover from.
- There is less blood loss
- Patients need fewer strong pain relievers for a shorter time.
- You can return to work and an active lifestyle much sooner.
What kinds of back surgery can use minimally invasive techniques?
There are many surgeries involving the spine that are suitable for these new techniques. Here are three of the most common spinal surgeries that used to need very invasive surgery and a long, and sometimes difficult, recovery.
- A discectomy is common back surgery. It involves removing herniated material that causes pain by pressing on a nerve root or the spinal cord itself. In the case of minimally invasive surgery, the surgeon removes no bone or muscle tissue. This operation often uses a local anesthetic that further minimizes recovery time.
- A laminectomy decompresses spinal stenosis, where the spine is too narrow for the spinal canal. The pressure causes pain and disability. The minimally invasive technique can eliminate the narrowing by a small incision in just one side. Many patients with this disability are elderly, and the faster and more efficient technique is safer and has better outcomes.
- Spinal fusion joins two or more vertebrae together permanently. Certain conditions can allow vertebrae to move against each other, causing disability and pain. A minimally invasive procedure can use several techniques, depending on where the problem is. By using these techniques, the patient’s recovery is much faster.
What kind of surgical instruments do the surgeons use?
First, the surgeon needs to get your muscles out of the way of the vertebrae. The spine and its parts are located very deep within your body. In an extensive open surgery, the surgeon cuts through the muscles and tendons and then sutures them back together.
With MIS techniques, the surgeon puts instruments through a tiny incision. She then puts devices, perhaps with a small video camera, into the opening. Don’t believe what you hear; surgeons rarely use lasers in these surgeries.
Some patients need instruments like screws and rods inserted to immobilize the spine for fusion to take place. In more extensive operations, surgeons remove a lot of muscle and other tissues from the spine’s surface. Tissue displacement is where much of the pain of the surgery originates, and the method creates considerable post-operative disability and recovery time.
Percutaneous (through the skin) placement of this hardware means that the screws or rods go through the small incisions. Using X-ray images, the surgeon uses guidewires that allow the appliance to slide along its path. The screws have temporary extenders. These extenders are outside of your skin and removed after the rods connect the screws.
What about my recovery time?
Even with minimally invasive surgery, the spine needs time to adjust to its new positions and to recover from the operation. It still takes about six weeks to get back in the swing of your normal activities. During this time, formal physical therapy sessions with home exercise will help get things back on track. Your back will return from recovery stronger and healthier than ever if you take physical therapy seriously.
How can I see if my condition is suitable for MIS?
If you are suffering from a spinal condition and have not found relief in non-surgical methods, call a Miami Back Specialists, spine doctor practice for Southern Florida. We can examine you, look at any images of your spine, and discuss possible surgical options.