Spine surgery is traditionally done as “open surgery,” meaning the area being operated on is opened with a long incision to allow the surgeon to view and access the anatomy. In recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique.
In a traditional, open surgery, long incision is made and muscles are moved to side in order to see the spine and get access to structures like intervertebral disc. One of the major drawbacks of open surgery is that the pulling or “retraction” of the muscle can damage the soft tissue which results in prolonged post operative pain and long time to recovery. Classic open surgery requires some amount of bone resection which further increases recovery time. Minimally invasive spine surgery was developed to treat spine problems with less injury to the muscles and other normal structures in the spine with out compromising the access to involved region. This is also known as keyhole surgery
Advantages of minimally invasive surgeries are Better cosmetic results from smaller skin incisions ,Less blood loss from surgery, Reduced risk of muscle damage since less or no cutting of the muscle is required, Reduced risk of infection and postoperative pain, Faster recovery from surgery and less rehabilitation required, Diminished reliance on pain medications after surgery.
Minimally invasive surgeries mainly done for intervertebral disc prolapsed with radiculopathy (leg pain). Fixations in degenerative spine can also be done in minimally invasive way. Procedures that require extensive decompression are not amenable to minimally invasive procedures.
Minimally invasive surgeries are done with the help of operating microscope. An inch of incision made, and muscles are reflected on that side and with the help of microscope intervertebral disc space approached and surgery done. The powerful light and mangifcation given by the microscope helps us to accomplish microsurgery.For fixations multiple small incisions are made and screws are applied through them under fluoroscopy. Decompression is done with operating microscope.
Thus with small incisions more is accomplished improving the patient care and accuracy of the treatment