Minimally invasive spine surgery (MISS) involves techniques that minimize the size of incisions and reduce tissue damage compared to traditional open surgery. These methods aim to achieve the same surgical goals with less postoperative pain, quicker recovery, and smaller scars.

Advantages of MISS

• Smaller Incisions: Typically less than 1 inch.
• Reduced Muscle Damage: Less disruption of surrounding tissues.
• Less Blood Loss: Minimal bleeding during surgery.
• Reduced Pain: Less postoperative discomfort.
• Faster Recovery: Shorter hospital stay and quicker return to daily activities.
• Smaller Scars: Less noticeable scarring.

Common Conditions Treated with MISS

• Herniated Disc: Removal of herniated disc material pressing on nerves.
• Spinal Stenosis: Decompression of the spinal canal to relieve nerve pressure.
• Degenerative Disc Disease: Treatment of disc degeneration and associated pain.
• Spondylolisthesis: Stabilization and realignment of slipped vertebrae.
• Spinal Tumors: Biopsy or removal of tumors in the spine.
• Spinal Fractures: Stabilization of vertebral fractures.
• Spinal Infections: Treatment of infections affecting the spine.

Types of MISS Procedures

• Microdiscectomy: Removal of part of a herniated disc using a microscope and small instruments.
• Laminectomy/Foraminotomy: Removal of part of the vertebra to relieve nerve pressure.
• Spinal Fusion: Joining two or more vertebrae to stabilize the spine, using smaller incisions.
• Kyphoplasty/Vertebroplasty: Stabilization of spinal fractures using cement injection.
• Endoscopic Spine Surgery: Use of an endoscope to visualize and treat spinal conditions.

Procedure Overview

• Preparation: The patient is positioned, and anesthesia is administered.
• Incision: A small incision is made at the surgical site.
• Dilation: Specialized instruments are used to gently separate muscles and tissues.
• Access: Tubes or retractors are inserted to create a pathway to the spine.
• Visualization: An endoscope or microscope is used to visualize the surgical area.
• Surgery: The specific procedure is performed using micro-instruments.
• Closure: The incision is closed with sutures or staples, and a small bandage is applied.

Recovery

• Postoperative Care: Pain management, wound care, and activity restrictions.
• Physical Therapy: Often recommended to aid recovery and strengthen the spine.
• Follow-Up: Regular follow-up appointments to monitor healing and progress.
• Activity Resumption: Gradual return to normal activities based on the surgeon’s advice.

Risks and Complications

While MISS is generally safe, potential risks and complications include:

• Infection: Risk of infection at the incision site or internally.
• Bleeding: Minor bleeding during or after the procedure.
• Nerve Damage: Risk of nerve injury, although minimized with precise techniques.
• Incomplete Relief: Possibility of persistent or recurrent symptoms.
• Anesthesia Complications: Risks associated with anesthesia.

When to Consider MISS

• Failed Conservative Treatments: When non-surgical treatments (physical therapy, medications) have not provided relief.
• Severe Symptoms: Significant pain, weakness, or neurological symptoms affecting daily activities.
• Specific Diagnosis: Confirmed diagnosis of a condition that is suitable for MISS, such as a herniated disc or spinal stenosis.