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Minimally invasive spine surgery

Minimally invasive spine surgery (MISS) is a surgical approach to treat spine conditions with smaller incisions than traditional surgery. It aims to reduce tissue damage and speed up recovery. Minimally invasive spine surgery (MISS) is a technique to treat spine conditions using small incisions.

• - MISS addresses herniated disks, spinal stenosis, and certain scoliosis types without large incisions.
• - Surgeons use special instruments, like tubular retractors and endoscopes, to access the spine through minimal incisions.
• - Real-time imaging, like fluoroscopy, helps guide the surgeon for precise targeting.

MISS or Minimally Invasive Spine Surgery

Benefits:

• - Causes less muscle and tissue damage
• - Leaves minor scars and reduces post-operative pain
• - Allows for faster recovery and shorter hospital stays
• - Lowers infection and complication risks compared to open surgery

Limitations:

• - May not be suitable for all spinal conditions
• - Some patients may need additional procedures if MISS doesn’t fully resolve the issue.

Minimally invasive spine surgery is ideal for those who need surgical intervention and prefer a quicker, less painful recovery.

What is the purpose of Minimally invasive spine surgery (MISS)?

The purpose of minimally invasive spine surgery (MISS) is to treat various spinal conditions with less disruption to surrounding muscles and tissues, leading to quicker and less painful recovery compared to traditional open surgery.

Prime purposes of MISS include:

• - Reduce pain and discomfort by minimising post-surgery tissue damage around the spine.
• - Speed up recovery through smaller incisions and less disruption, helping patients return to daily activities faster.
• - Lower the risk of complications, such as infections, bleeding, and scarring.
• - Maintain spinal stability by preserving more of the natural spinal structure, which supports better long-term outcomes.
• - Enable outpatient procedures, allowing many patients to go home the same day.

MISS addresses spinal issues with greater efficiency, safety, and comfort.

MISS

What kinds of spine operations are possible using MISS?

Orthopaedic surgeons use Minimally invasive spine surgery (MISS) for several types of spine operations, including:

• Discectomy: It removes a portion of a herniated or damaged disk to relieve pressure on surrounding nerves, often used for sciatica or nerve pain.
• Spinal Fusion: Stabilises parts of the spine by fusing two or more vertebrae using implants and bone grafts, commonly for conditions like spinal instability or degenerative disk disease.
• Laminectomy: It removes a portion of the vertebra (lamina) to relieve pressure on the spinal cord or nerves, often for spinal stenosis.
• Vertebroplasty and Kyphoplasty: It treats spinal fractures, often bcz of osteoporosis, by injecting bone cement to stabilise the vertebra and reduce pain.
• Foraminotomy: Enlarges the space where nerves exit the spinal column, reducing pressure on pinched nerves and easing symptoms like numbness or tingling.
• Artificial Disk Replacement: It replaces a damaged spinal disk with an artificial one to maintain motion in the spine, typically used as an alternative to spinal fusion.

MISS allows for these procedures with smaller incisions, resulting in faster recovery, less pain, and fewer complications versus traditional open surgery.

What takes place at some stage in a minimally invasive spinal fusion procedure?

During a minimally invasive spinal fusion procedure, the following steps typically take place:

• Preparation: The patient is placed under general anaesthesia to ensure they remain unconscious and pain-free throughout the procedure.
• Incision: The surgeon makes one or more small incisions near the affected spine area.
• Access to the Spine: A tubular retractor, a specialised device, is inserted through the incision to gently move aside muscles and tissues without cutting them. This access creates a pathway to the spine while minimising tissue damage.
• Removal of Damaged Disk or Bone: The surgeon may remove parts of a damaged disk or other bone structures to create space for the fusion and relieve pressure on nearby nerves.
• Insertion of Bone Grafts and Implants: Bone graft material from the patient or a donor is placed between the vertebrae to promote fusion. Implants, like screws, rods, or cages, may also be inserted to stabilise the spine and hold the vertebrae in position.
• Closure: The surgeon removes the retractor and closes the small incision(s) with sutures or staples. Bandages are applied to cover the incisions.
• Post-Surgery: The staff moves the patient to a recovery area for monitoring. Because the procedure is minimally invasive, many patients experience less pain, reduced muscle damage, and a shorter recovery time than traditional fusion surgery.

Minimally invasive spinal fusion aims to stabilise the spine, reduce pain, and allow for faster recovery by minimising disruption to surrounding muscles and tissues.

What occurs after a spinal fusion MIS?

After a minimally invasive spinal fusion (MIS) procedure, the recovery process unfolds in stages to help ensure proper healing and the successful fusion of vertebrae.

Here’s what typically occurs:

• Immediate Recovery: After surgery, the medical staff moves the patient to a recovery room to monitor vital signs, pain levels, and the initial response to the procedure. Due to the less invasive nature of MIS, pain is often milder than with traditional open surgery, though patients may receive pain relief medication to manage discomfort.
• Hospital Stay: Depending on the individual case, the patient may stay in the hospital for one to three days. During this time, physical therapists may work with the patient on simple movements, such as sitting up, standing, and beginning to walk. This gentle activity helps prevent complications like blood clots and encourages circulation.
• Pain Management: The medical team typically prescribes pain medications, such as anti-inflammatories or opioids, for the first week or two. As healing progresses, the goal is to shift to milder pain relief options and eventually stop medications altogether.
• Activity Restrictions: The affected patient must avoid heavy lifting, bending, twisting, and other strenuous activities for several weeks to allow the fusion to stabilise. Doctors recommend a back brace to support posture and limit movement during early healing.
• Physical Therapy: Once the doctor clears, physical therapy begins, often within a few weeks after surgery. Physical therapy focuses on strengthening the core and back muscles, improving flexibility, and rebuilding stability in the spine. Patients gradually increase their activity level as they gain strength.
• Bone Fusion Process: Full fusion of the vertebrae can take several months to a year. During this period, bone graft material and the body’s natural healing process encourage new bone growth, stabilising the fused area. Surgeons take imaging tests and X-rays to track the fusion progress.
• Follow-Up Appointments: Patients attend regular follow-up appointments to assess healing and address concerns. The doctor may adjust the treatment plan based on recovery progress, pain levels, and imaging results.
• Long-Term Outcomes: Once fully healed, most patients experience reduced or eliminated pain in the treated area, allowing them to resume normal daily activities. The success rate of minimally invasive spinal fusion is high, and most individuals enjoy improved life quality with fewer limitations on movement.

With careful adherence to recovery guidelines, patients can often return to regular activities within a few months, achieving a stable and pain-free spine in the long term.

Minimally invasive spine surgery (MISS) offers a valuable advancement in various spinal conditions. By utilising smaller incisions and specialised techniques, MISS reduces tissue damage and enhances recovery compared to traditional open surgery. Key benefits include:

• - Decreased post-operative pain and faster recovery times
• - Lower risk of complications such as infection and excessive bleeding
• - Improved precision and better preservation of surrounding structures

As a result, many patients experience relief from pain and functional improvements, allowing them to return to their daily activities more swiftly. While MISS is not suitable for every spinal condition, it offers a promising option for those requiring surgical intervention.

Overall, the continued evolution of minimally invasive techniques in spine surgery enhances patient outcomes, reduces recovery times, and improves the quality of life for individuals facing spinal challenges. As advancements in technology and surgical methods progress, MISS will likely become an increasingly standard approach in spinal care.