Introduction
Minimally invasive surgery (also known as 'keyhole' surgery or simply by the abbreviation 'MIS') involves carrying out surgical procedures without the need to access internal tissues via large incisions. Spinal surgery is commonly performed using open techniques that require larger incisions. In minimally-invasive spinal surgery, smaller incisions are made and surgery is performed with specialised retractors and surgical instruments to achieve the same operative goals as open surgery. This approach leads to less trauma to the skin, muscle and other soft tissues. Minimally invasive surgery has a number of important advantages over conventional surgery. These are…
- Quicker recovery times.
- Less scarring to the skin - most minimally invasive surgery requires a small number of incisions (generally about 2cm long).
- Muscle damage is reduced.
- Less postoperative pain.
- Potentially lower risk of infection.
- Potentially less blood loss during surgery.
Indications
Minimally invasive spinal surgery may be used to treat the following conditions…
- Fractures in vertebrae.
- Degenerative disc conditions.
- Disc prolapse.
- Infections in the spine.
- Spinal abnormalities (e.g. scoliosis).
- Spinal stenosis.
- Spinal tumour.
- Instability of the spine.
Minimally invasive spinal surgery is commonly used for the following procedures…
- Discectomy.
- Spinal decompression.
- Lumbar spinal fusion.
Minimally invasive surgical techniques for spinal surgery
Minimally invasive surgical techniques in spinal surgery involve several different possible approaches, depending on the condition and location. Instead of cutting through muscle tissue, a tubular retractor allows the muscle tissue to be pushed gently to one side using a succession of tubes, increasing in size. Once the final tube is in place, the surgeon is able to carry out the necessary procedure/s using minimally invasive techniques. When the procedure is complete, the tubular retractor is removed and the muscle tissue moves back into its normal position. Where artificial components, such as rods and screws, need to be affixed to a section of the spine, these can be brought into position through very small incisions (the word 'percutaneous' means 'through the skin') using guidewires.