If you have come to this page there is a high chance that someone close (or you yourself) needs a spine surgery.The purpose of this article is to not only answer the question what is minimally invasive spine surgery ? , but to also give adequate information with complete overview of minimally invasive spine surgery aka MISS aka MIS Surgery.The spinal problems have become very common nowadays and many people even in their younger life require spine procedures. As compared to the traditional open spine surgery the minimally invasive spine surgery offers multiple benefits and also decreases the amount of complications associated with open spine surgeries. 

 

Diseases Which Can Treated With MISS

 

Due to the cutting edge technology available today to medical professionals, there is a dramatic change in the way treatment is offered to the patients.The spine treatment has been revolutionized in the last two decades. As the medical technology continuously Bangs at the doorstep of treating Spine surgeons, which specifically includes

 

Equipments which greatly enhance the vision (for example microscope & endoscopes) & very fine instruments which can pass through you very narrow working spaces and still Get the job done very precisely. A few decades back it started with only a very few diseases which could be treated with mis technique ,but as the advancements came,The list kept growing larger gradually now there is a huge list of spinal Diseases which can be treated very effectively with minimally invasive spine surgery.

 

These include:

 

• Disc problem / Lumbar PIVD / Disc protrusion / Disc herniation

• Cervical Canal Stenosis or simply said Cervical Stenosis

• Degenerative disc disease or DDD

• Spondylolisthesis /spondylolysis

• Cervical spondylosis  & Cervical PIVD

• Spinal fractures

• Spinal tumors

 

How MISS (Minimally Invasive Spine Surgery) Works & Equipment required

 

Minimally invasive spine surgery Comes with a lot of benefits to the patients, to the doctors and it has now been recommended as the standard way of treatment for most of the spinal conditions. However these kind of special techniques require highly specialised instruments and assisting devices which are essentially visual in nature which help in visualising the exact problem with very high magnification.

 

A few of the essential components of of MISS are described under:

 

1. Operating Microscope : Operating microscope has revolutionized the spine surgery in last two decades and has led to do surgeries which are very very less invasive providing very good pain relief and very less post operative rehabilitation.

2. Surgical Loupe : Surgical loupes are special kind of spectacles which include a magnification device over directly the Surgeons Eye. this leads upto 400% magnification And the surgeon is able to do the job in a very fine and and much more refined way using a very small incision.

3. Endoscopes: Latest to the addition of MISS  is the spinal endoscope.This cutting edge technology provides 1000x magnification. Spinal Endoscopes have revolutionized the way spine treatment is done and now many of the so-called major spine surgeries are now getting converted into minor Procedures. Most of the spine procedures under the endoscope are done without anaesthesia without stitches, without pain and with no blood loss. This leads to patients getting discharged the same day that is the so-called day care procedure.

4. The best endoscopes come from Joimax company and it is a patent German technology. There are very few surgeons in India who are experienced to do spinal endoscopy (Tessys) and who have trained themselves in this technology by going to Germany and learning it First Hand the masters in Germany And Austria.

 

Benefits Of MISS

 

Minimally invasive spine surgery Benefits are multifold in nature and it has revolutionized the way Spine Surgeries are done in India and around the globe. These surgeries can be termed as biological in nature that is to say a that day a aa are intended to decrease the amount of of collateral damage caused in order to to reach or approach the problem area in the spine while maintaining same or higher level of surgical procedure at the target site.This leads to considerable decrease in size of the cut (incision).

 

And the moment the size of cut (incision) goes small it leads to a series of benefits. 

 

• No Large Scar marks after Surgery

• Very less Blood Loss

• Very less post-operative pain

• Easier  and faster rehabilitation

• Sooner recovery and return to work

• In some cases the procedure can be done as a daycare procedure that is no need to say in hospital. 

• Gentle forms of anaesthesia (Local) 

 

Various MISS Treatments

 

There are various types of minimally invasive spine surgery.With Rapid growth of Medical Technology in last decade many of the complex spine surgeries have metamorphosed into Relatively simple easy and less complicated spine surgeries. the following list is not exhaustive but talks about various spine surgeries recharge now regularly done using the mis techniques.

 

1. Endoscopic Discectomy of a Herniated disc

2. Endoscopic Laminectomy & Endoscopic Decompression for Spinal stenosis

3. Microscopic Discectomy or MicroDiscectomy.

4. Kyphoplasty

5. Vertebroplasty

6. Cervical Decompression

7. ACDF (Anterior Cervical Discectomy & Fusion)

8. Radiofrequency Ablation (RFA)

9. Spinal decompression and stabilization 

10. Spinal fracture treatment 

11. TLIF Procedure for Spondylolysis & Spondylolisthesis

12. Spinal deformities Treatment

 

Risk Factors & Complications

 

As we already know, none of the spinal procedures come without a complication & MISS  is not an exception. However this is worth mentioning that when there is a comparison of minimally invasive spine surgery vs open surgery , MIS  surgeries  are better on the scale of complications as they will have less number of complications because these methods are known to respect the Anatomy of the body and no unnecessary tissues are damaged in order to find access to the problem area. 

 

Also a very common question asked in OPDs is what is the success rate of minimally invasive spine surgery ? Well just to clarify that the success rates of mis surgery versus traditional open spine surgery are exactly the same.

 

MISS offers following benefits as far as complications are concerned :

 

• Risk of infection is less as compared to open surgery

• The time of surgery is generally less. 

• The blood loss is considerably less leading to less chance of patient requiring a blood transfusion.

• There is a significant decrease in pain after the procedure as  there is a very less tissue injury. 

• There is a shorter stay in the hospital.

• There is faster recovery and faster return to work.

• The rehabilitation is also significantly shortened.

 

Who Needs Minimally Invasive Spine Surgery

 

As we already know that many of the spine  procedures are now done in a minimally invasive way using the technology Which is now available to us. This always remains a question that it if one needs a spine procedure then easy a good candidate for a a minimally invasive spine surgery for endoscopic spine surgery or he still requires a very traditional open spine surgery .Which kind of surgery to perform is is generally a description of a spine surgeon handling the case.

 

• It depends upon the the experience in training of the surgeon how much he is used to performing  the spine surgery using the minimally invasive techniques. many surgeons in India are very comfortable using microscopes but what are not regularly using endoscopes because it’s very  recent Technology and many of the the surgeons are not trained To use them.

• Video also another very important factor is the place where the spine surgery needs to be done at some of the times the spine surgeon needs to go to a place pages almost not possible to approach using minimally invasive techniques. then the surgeon for an open procedure.

• In some of the cases the surgery is started as a minimally invasive procedure but during the surgery if  surgeon realises that the amount of work done on the spine is almost an achievable by using the minimally invasive method the surgeon decides to  to convert the procedure into an open 1 and does the the conventional method.

 

Conclusion

 

Minimally invasive techniques spine surgeries have done and immense and a breathtaking job of making a previously dreaded spine surgery into a simpler easier and somewhat more palatable, safer & than before. As the technology advances the list of spinal surgeries which were previously “OPEN ONLY” are slowly finding its way in MISS possible list.