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Benefit of Minimally Invasive Spine Surgery

Benefit of Minimally Invasive Spine Surgery

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Over the Past Decade, Technology advancements have changed the face of spine surgery. Dr. Rahul Gupta, Senior Surgeon, Fortis Hospital, Noida says that technology has greatly improved over the past 10 to 20 years, what previously could only be done through open surgery now can be accomplished through small incisions, offering patients less pain , reduced blood loss, less scar tissue formation and faster return to normal activity.

When most people think about having spine surgery, they typically imagine a lengthy and painful procedure. They envision days, possibly weeks spent in the hospital, and an unpleasant recovery. Even more frightening, many worry that the procedure will not have the desired outcome that they will be left in a worse condition than they were prior to surgery.

Over the Past Decade, Technology advancements have changed the face of spine surgery. Dr. Rahul Gupta, Senior Surgeon, Fortis Hospital, Noida says that technology has greatly improved over the past 10 to 20 years, what previously could only be done through open surgery now can be accomplished through small incisions, offering patients less pain , reduced blood loss, less scar tissue formation and faster return to normal activity.

Through MIS procedures, surgeons can effectively treat spine disorders with minor disruption of spine anatomy, which is normally associated with traditional, open surgery. In addition to common ailments such as sciatica, which can be alleviated by a simple micro discectomy, minimally invasive procedures are used to treat other problems of the spine as well. This includes, but isn’t limited to conditions such as spinal stenosis, scoliosis, fractures, tumors, infections, spinal instability or nearly all conditions of the spine.

What is MIS:-

In general, the goal of MINIMALLY INVASIVE SPINE SURGERY (MIS) surgery is to stabilize the vertebral bones and spinal and spinal joints or relives pressure being applied to the spinal nerves- often a result of conditions such as a spinal instability, bone spurs, herniated discs, scoliosis or spinal tumors. The term “minimally invasive” in the cases, when describing a surgical procedure, refers to a technique using small incisions to gain access to the particular area of the body needing treatment.

By avoiding a larger incision, there can be less force the retractors on the surrounding tissues, less tissue dissection, and usually better preservation of the surrounding blood supply to the tissues in the operated are. Ideally, these factors lead to quicker healing and a recovery with less pain, although these differences have not been proven conclusively. For an open procedure (non-MIS), the surgical wound is larger and more dissection is required. Retraction on the muscles, when kept in place during a long procedure, has been shown to cause damage to these muscles, with some of these effects possibly permanent. Night and day, what once were often times considered risky and required extensive recovery can now be performed through small incisions as an outpatient. These advances are ultimately better for the patient with less complication.

As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. The comparison between minimally invasive and open surgery can be made when describing a lumber fusion. This procedure typically has the patient lying face down during the surgery, with the work done on the back side (posterior). With an open case, the incision is usually in the midline and the muscles are spread to the sides by retractors. Since the Natural tendency of the muscles is to return to the midline, the force can be fairly high at the spot where the retractor is in contact with the muscles. If the surgeon tries to minimize the length of the incision with the open technique, he/she may have to use the retractors to spread harder to see the areas where the work  needs to be done. These retractor –induced forces can be reduced somewhat by, paradoxically, making a longer incision. With a minimally invasive approach, usually a tubular retractor is used. After the appropriate level of the spine is identified with x-ray, first small, then sequentially larger tubes are placed, one over another, or dilate (expand) the opening. The force on the muscles is distributed more equally in a direction like spokes on a wheel, with less direction like spokes on a wheel, with less localized pressure and thus less potential for muscle damage.

How Minimally Invasive Spine Surgery Works

Because the spinal nerves, vertebrae and discs are located deep inside the body, any approach ot gain access to the spinal area requires moving the muscle tissue out of the way. In general, this is facilitated by utilizing a small incision (s) and guiding instruments and/or microscopic video cameras through these incisions. Contrary to popular belief, lasers are very rarely used in MIS surgeries. A number of methods can be used to minimize trauma during MIS surgery. Some of the more common techniques include:

  • Tubular Retractor:
  • Percutaneous placement of screws and rods:
  • Direct lateral access routes:
  • Thoracsopic access route:

Common MIS Surgery Treatment Options

A number of specific techniques have been deployed for MIS surgery. Though the field continues to develop, the list below highlights some of the most common options:

  • Discetomy
  • Spinal decompression
  • MIS TLIF (Transforaminal lumbar interbody fusion)

Are you a candidate for MIS surgery?

Your doctor will be able to tell you which MIS surgeries, if any, might be an option for treating your condition. In some situations, MIS surgery may not be as safe or effective as traditional open surgery. If so, your doctor will be able to inform you about the relative risks and benefits. In addition, there are some conditions that are not truly accessible with MIS surgery.

Risks associated With Minimally Invasive Spine Surgery

It’s important to remember that even though spine surgeries can be done using a minimally can be done using a minimally invasive technique, it is still a surgery, and therefore not without risk, Potential risks associated with surgery include anesthesia complications, blood dots, allergic reactions, and adverse effects due to undiagnosed medical problems, such as silent heart disease. Injury to nerves and blood vessels can also occur In addition, during minimally invasive spine surgery, the surgeon may have to convert to an open surgery if circumstances require.
Dr. Rahul Gupta is the man behind the department of Brain and spine surgeon at Fortis Hospital, Noida surgeon at Fortis Hospital, Noida. He was trained at Nagoya Japan, which has made his a expert in Endovascular procedures. Dr. Gupta has rich experience of working as faculty in teaching government institutes. He has performed thousands of complex vascular, endo-vascular, skull base and minimally invasive brain surgeries. He has mastery in dealing  with spine ailments. He has mastery in dealing with spine ailments.
He has been actively involved in teaching and research activities in teaching and research activities in the Department of Neurosurgery at PGIMER, Chandigarh and at G B Pant Hospital, Delhi.

 

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