Minimally invasive surgery is a name given to wide a range of procedures with a common goal: treatment that is less traumatic to the patient and that allows a faster return to a normal lifestyle and activities. In surgery of the spine, three main factors are contributing to a rapid proliferation of options for patients who once faced more extensive open surgeries and a prolonged recovery time.
Less Invasive Spine surgery can mean:
– smaller surgical incisions
– decreased operative time
– avoiding or minimizing the need to cut through muscle
– reduced loss of blood
– reduced scarring
– a more rapid healing time
Traditionally, surgical treatment for many injuries and diseases of the spine meant a large open incision, a fusion (or permanent joining together of bones) and a lengthy recovery period. Non-fusion technologies are replacing that scenario, as in the case of degenerative disc disease, in which the normal discs in the spine become thinner and weaker. As the cushioning effect is lost, the patient experiences pain and stiffness at the site of the damaged disc or discs. Fortunately, only about 20% of cases require surgical treatment, which, until recently, was fusion of the affected vertebrae (the bones surrounding the disc.) By eliminating motion, the surgeon eliminated the patient’s pain.
By comparison, fusion requires an open incision in the patient’s back that may range in length depending on how many discs are affected. Patients with disc replacement usually begin physical therapy at 6 weeks and can return to normal function in 3 months. Patients who undergo fusion begin physical therapy at 3 months and return to most activities at 6 months. Preliminary results from the trial indicate that disc replacement and fusion provide comparable medium-term results; long-term results with disc replacement remain to be assessed. At present, this surgery is restricted to diseased discs in the lumbar spine, the area that corresponds to the lower back.
Physicians at Coast Orthopedic Surgery Center also perform a number of minimally invasive surgeries with the use of endoscopes (an instrument that provides a view the interior of the torso) and arthroscopes (an instrument that provides a view inside a joint). This technology allows orthopaedic surgeons to address various conditions of the spine, using only small incisions to position the scopes, a miniaturized camera, and small instruments. One of the most successful of these procedures is micro-discectomy to provide relief of pain caused by herniated discs that are compressing or pinching a nerve in the spine. A small incision of an inch or so is made, the disc fragment is removed from the spine, and pressure is taken off the nerve. Patients are generally kept at the surgery center overnight and go back to work in about a week to ten days.
Additional endoscopic surgeries include: