Spine Surgery

Spine surgery is traditionally "open surgery." This means that the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with minimally invasive surgical techniques.

Minimally invasive spine surgery (MISS) accomplishes the same goal as open surgery, but through smaller incisions.

  • With long incisions, there is more associated muscle damage. 
  • Because the incision is smaller with minimally invasive spine surgery, it avoids significant damage to the muscles surrounding the spine. Typically, this results in less pain after surgery and a faster recovery. However, because you are operating through a smaller opening, the learning curve for minimally invasive spine surgery is longer, so it is technically more challenging for the surgeon. 

The criteria for minimally invasive spine surgery are the same as those for traditional open surgery.

  • Spine surgery is usually recommended only when a period of nonsurgical treatment — such as medications and physical therapy — has not relieved the painful symptoms caused by your back problem.
  • In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disk or spinal stenosis.

There are numerous minimally invasive techniques. The common thread between all of them is that they use smaller incisions and cause less muscle damage.

Minimally invasive techniques can be used for common procedures like lumbar decompression and spinal fusion.

  • Decompression relieves pressure on spinal nerves by removing portions of bone or a herniated disk.
  • Spinal fusion corrects problems with the small bones of the spine (vertebrae). The basic idea is to fuse together the painful vertebrae so that they heal into a single solid bone.

This article focuses on decompression and spinal fusion with a minimally invasive technique. 

For a complete overview of spinal fusion including approaches, bone grafting, complications, and rehabilitation: Spinal Fusion.

Description

Minimally invasive spine surgery is sometimes called less invasive spine surgery. In these procedures, doctors use specialized instruments to access the spine through small incisions.

In a traditional open surgery, the doctor makes an incision that is 5 to 6 inches long, then moves the muscles to the side to see the spine. With the muscles pulled to the side, the surgeon can:

  • Access the spine to remove diseased and damaged bone or intervertebral disks.
  • Easily see where to place screws, cages, and any bone graft materials necessary to stabilize the spinal bones and promote healing. 
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