Who qualifies for Minimally Invasive Spinal Surgery?

There is a range of conditions that can reduce mobility in the back and cause back pain, two common conditions are Spondylolisthesis and Lumbar Spinal Stenosis. Both conditions can cause symptoms that can impact a person’s quality of life.

Fortunately, minimally invasive spine surgery (MIS) can help to cure these symptoms, and in this article, we will talk about who can qualify for such surgery and what it entails.

What is Minimally Invasive Spinal Surgery?

Minimally invasive spine surgery is much safer, faster, and has a quicker recovery time when compared to open spine surgery. This is because the trauma caused by the surgery is less severe.

The benefits of minimally invasive spinal surgery are:

• The incisions to the skin are smaller (sometimes just several millimeters) which means there is less scarring and the cosmetic results are less noticeable. 
• Patients lose less blood during MIS.
• The chances of muscle damage are significantly reduced as no incisions are made to the muscle itself.
• The risk of infection is reduced.
• There is less postoperative pain.
• The recovery time is much quicker, with less rehab required.
• Patients are less reliant on painkillers after surgery.
• Some MIS procedures only require a local anesthetic to be used. This is a much better option as some people can react poorly to general anesthetic.

Does MIS present any risks?

Just like any operation, minimally invasive spinal surgery does present an element of risk, however, this level of risk is much smaller when compared to open spine surgery.

Potential risks include:

• Some people can experience adverse reactions to anesthetic.
• Localized infections are a possibility.
• Surgery can sometimes result in unexpected blood loss.
• In some cases, it might not be possible to complete the surgery. If this is the case then, a second MIS operation may be required, or perhaps open surgery.

How does Minimally Invasive Spinal Surgery work?

The components of the spine that may need to be operated on, such as the nerves, vertebrae, and discs are situated deep inside a person’s back. This means muscles need to be moved out of the way for any procedure to be performed.

This requires a small incision and technology to ensure the operation is a success. A surgeon would need to utilize guiding instruments and microscopic cameras to enable minimally invasive surgery.

To help reduce the chances of any trauma during surgery, there are a number of techniques that can be used, which include:

• A Tubular Retractor – A technique that uses progressive dilation of soft tissue instead of cutting through muscles. After an incision is made, these tubes move the muscles out of the way to expose the problem area.
• Percutaneous Placement of Screws and Rods – Instruments such as rods and screws may be placed through small skin incisions, without cutting away any of the muscle. Guidewires are placed beneath the skin with the help of x-ray imagery to create a clear path for the surgeon to place the screws and rods, with temporary extenders creating more space.
• Thoracoscopic Access Route – Depending on the problem, the surgeon may need access to the front parts of the thoracic spine. These are located in the chest and surround important organs such as the heart and lungs. 
  A Thoracoscopic Access Route removes the need for large incisions in the chest and also the removal of a rib. Instead, this technique uses multiple small incisions and microscopic cameras. 
• Direct Lateral Access Routes – This technique is commonly used for operations involving the lumbar spine. It is performed on the patient’s side as the amount of muscle that blocks the affected area is minimal. After an incision, access is then granted via a tubular retractor. 

What types of surgery are classed as MIS?

Common surgery types that use these techniques are spinal decompression, spinal fusion, and discectomies. 

• Discectomy – A Discectomy cuts away part of or all of the soft tissue (the disc) that is placing pressure on the nerves or spinal cord. This tissue protects the vertebrae but over time, they can lose water and eventually move out of position. 
• Spinal Decompression – Spinal decompression removes part of the vertebrae (usually the lamina if the patient suffers from spinal stenosis) to create space in the spinal column and alleviate pressure. 
• Spinal Fusion – Transforaminal Lumbar Interbody Fusion (TLIF) is a procedure that places a bone graft between affected vertebrae (usually after decompression surgery) to provide stability. The bone graft is held in place using screws and rods, fusing the bones together. 

What Conditions are treated using Minimally Invasive Spinal Surgery?

Conditions that may require minimally invasive spinal surgery are; a herniated disc, degenerative disc disease, lumbar spinal stenosis, spondylolisthesis,(and other spinal instabilities), spinal infections, vertebral compression fractures, scoliosis (and other spinal deformities), and spinal tumors. 

Who qualifies for minimally invasive spinal surgery?

Candidates for minimally invasive spinal surgery would need to consult with their doctor to check whether they qualify for such a procedure. This type of surgery is used to treat the conditions mentioned above, however, this may depend on the severity of the condition.

In some cases, MIS surgery may not be deemed as a safer or more effective option to open spinal surgery.  Your doctor will be able to provide information about the potential risks and benefits of either form of surgery.

Some back conditions cannot be treated by MIS surgery.

What is the best option for Minimally Invasive Spinal Surgery?

One of the best, if not the best spondylolisthesis treatment is surgery that installs a TOPS System. A TOPS Posterior Arthroplasty System can help to cure Spondylolisthesis and Spinal Stenosis without any fusing, ensuring the patient keeps the mobility in their back, while still having stability.

The mechanical implant is installed following decompression surgery and replaces the removed bone and soft tissue. The device works on a single level, between L2 and L5 of the spine which are the main areas that are affected by conditions such as Spinal Stenosis. 

Unlike spinal fusion, a TOPS system allows the spine to move a natural way, helping the patient lead a normal and active lifestyle.