Minimally Invasive Spine Surgery

Spinal operations are performed for various conditions to achieve mainly the following aims:

• to stabilise spinal segments
• or to relieve compression of spinal nerves.

Spinal instability can be the result of degenerative changes from ageing, previous injury to the spine, trauma causing fractures or primary bone tumour or distant spread from other non-bony cancer. Nerve compression can occur from herniated disc, spinal stenosis from bone spur formation and tumour.

An example of spinal instability and nerve root impingement is degenerative spondylolisthesis

Not all spinal surgery can be achieved using the minimal invasive approach. Whenever it is appropriate, often minimal invasive surgery has its clear advantages such as faster, safer and require less recovery time. Based on the premise that minimal invasive surgery cause much less collateral damage when performing the same procedure in an open method.

In open approach to spinal surgery, the incision made is usually bigger and longer. The need to expose the area of concern during surgery would require the dissection and stripping of muscles. This process will inevitably lead to more bleeding, exposure to infection and leading to possibly a cosmetically better looking after surgery scars from smaller incisions. With bigger incisions and muscle stripping, often patient feels more pain and will need more medication to control pain. Painkiller medication have many side effects which include inducing nausea, vomiting and drowsiness. In turn this will hamper the progress of recovery.

With minimal invasive surgery, often the incisions are smaller, the muscles are split rather than dissected off the bones which leads to less bleeding.  Post operatively, muscle pain is much less and the muscle function recovers faster. Hence the added knock-on advantage would be the need for less painkiller medication and faster return to normal function.

It is important to note that not every patient is a candidate for a minimally invasive approach. There are specific indications for minimally invasive surgery – when it works well and when it should not be done from a safety stand point or whether the goal of surgery can be achieved via minimal invasive approach. Each surgery must be customized for the patient and the technique. However, before surgery is even considered, your spine care team may decide, during your evaluation, that there are other treatment options that should be tried first before surgery is considered.

So, in summary:

Minimally invasive spine surgery offers several advantages over open surgery, including:

• Shorter duration of anaesthesia.
• Less blood loss during surgery.
• Less muscle and soft tissue damage.
• Reduced risk of infection.
• Less pain after surgery.
• Less pain medication use.
• Possibly better cosmetic result (a few tiny scars vs one large scar).
• Shorter hospital stay (a few days vs about a week).
• Shorter recovery time (a few months vs up to a year).
• Quicker return to daily activities, including work.