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In the not so distant past, neck, back, and spine surgery was always performed as an open procedure. Today however, advances in image-guided technology, surgical instrumentation, and biotechnology have fostered the emergence of minimally invasive spine/back surgery for the symptomatic relief of many debilitating spine conditions. From herniated disc repair in the lumbar spine or cervical spine to spinal fusion as a corrective action for scoliosis conditions, minimally invasive spinal surgery may offer benefits when compared to traditional open spinal surgery procedures in the appropriately selected patients. There are many conditions that are better served with traditional gold standard approaches, while some conditions can be addressed effectively through a minimally invasive or minimal access spine surgery.
Minimally invasive endoscopic spine surgery (or laser spine surgery as it is often called) aims to reduce this risk by approaching the spinal column through one or several small incisions. Using the aid of image-guided technology (endoscope), spine surgeons conduct spinal procedures, like disc surgery and spinal fusion, through the insertion of a tubular retractor (portal) and special instrumentation.
Conditions Treated by Minimally Invasive or Limited Access Surgery at University Spine Associates:
- Lumbar Herniated Disc – We utilize both a microdiscectomy approach as well as minimally invasive tubular access to limit the dissection to the spinal musculature. Nearly all our patients go home several hours after the surgery that is done on an outpatient basis.
- Cervical Herniated Disc – When appropriate, patients who have a herniated disc in their neck that causes arm pain only are good candidates for a posterior cervical foraminotomy. Traditional cervical foraminotomies work very well; but can be associated with a painful surgical exposure that takes a few weeks to recover from. Minimally invasive cervical foraminotomy accomplishes all the same benefits as open foraminotomy but through a very limited incision. Most patients go home the same day as the surgery. This operation, when appropriately selected, can yield excellent relief of arm pain that results from a herniated disc without the need for a fusion or artifical disc replacement.
- Spinal Fusions – Most spinal fusions at our institution require traditional “gold standard” approaches. There are some conditions and patients that are good candidates for minimally invasive spinal instrumentation and fusion. This allows us to access the spine through small stab like incisions rather than one longer incision. We also utilize a technique that allows for a spine to be reconstructed through a single posterior approach rather than an anterior and posterior staged operation.
It is important to remember that while emerging techniques may offer new benefits, many conditions and patients are still best served with true and tried approaches that can yield excellent outcomes. It is important for patients to seek out care where all techniques are an option, so that the best approach is used. |
