Many Americans suffer from back injuries and conditions that cause them pain. According to research made available by the U.S. Department of Health and Human Services, lower back pain affects up to 80% of the U.S. population at some point in life. Sometimes back pain is not caused by a chronic condition or serious injury. However, many people with back pain do suffer from back issues that require surgery.
Traditionally, back surgery is performed in an open procedure in which the surgeon must get to the spine through an opening made by a large incision in the back or abdomen. However, in recent years, minimally invasive spine surgery has become the preference of both doctors and patients. So what can you expect from open spine surgery vs minimally invasive spine surgery?
What to Expect With Open Surgery
During standard open spine surgery, the surgeon creates a large incision (usually about six inches long) in the back and dissects the spinal muscles to pull them away from the bone in a process called retraction. Once they visualize the bones of the spine, they will begin the necessary spinal procedure. Certain open spine surgeries require the surgeon to go in from the front through a large abdominal incision. According to the American Aca Open surgery requires:
- Large incisions
- Muscle retraction
- Long surgery times
- Long recovery times
How Does Minimally Invasive Spine Surgery Differ from Open Surgery?
In minimally invasive spine surgery(MISS), surgeons use specialized instruments to perform spinal procedures through small incisions. Because the incisions made during MIS are much smaller than in open procedures, there is less chance of muscle and soft tissue injury. The benefits of minimally invasive spine surgery include:
- Smaller incision
- Little or no muscle cutting
- Less bleeding during surgery
- Shorter hospital stays
- Most patients are discharged within 2 or 3 days but some procedures can be performed on an outpatient basis.
- Smaller risk of infection
- Less pain after surgery
- Decreased reliance on pain medication
- Faster recovery
- Less rehabilitation is needed
- Patients return to work and activities more quickly
- Less scarring
Minimally Invasive Surgical Procedures
The following spinal surgeries can be performed using a minimally invasive technique:
- Kyphoplasty: Also called balloon vertebroplasty, kyphoplasty is used to repair vertebral compression fractures. A needle is inserted into the fractured vertebra with x-ray guidance. A balloon device is passed through the needle and into the vertebral body. The surgeon carefully inflates the balloon to expand the fractured vertebra. The balloon is deflated, leaving a cavity which the surgeon fills with bone cement.
- Spinal Fusion: Spinal fusion is a procedure used to permanently join two or more bones in the spine to prevent movement between them. Spinal fusion is used to treat degenerative disc disease, spondylolisthesis, spinal stenosis, and fracture. Fusion can be performed on both the cervical spine and the lumbar spine using different minimally invasive methods.
- Laminectomy: A laminectomy is a procedure to remove the spinous process and lamina of the affected vertebra. The surgery relieves pressure on the spinal nerve roots by creating more space in the spinal canal. This procedure is primarily performed to relieve symptoms of spinal stenosis.
- Discectomy and Microdiscectomy: The surgeon removes either a part of or an entire intervertebral disc to relieve nerve pressure. The difference between the two procedures is that a microdiscectomy is performed using an operating microscope. These procedures are used to remove either ruptured or herniated discs.
- Spinal Cord Stimulator Placement: A spinal cord stimulator is a small device that sends electrical current to the spinal cord to relieve pain. This device is implanted in a minimally invasive procedure through a small incision in the back.
- Interspinous Spacer Placement: A spacer is an implant that sits between two interspinous processes in the lumbar spine. These spacers are inserted in a minimally invasive procedure. The purpose of interspinous spacers is to increase the space between processes and relieve the symptoms of spinal stenosis.
- Cervical Disc Replacement: This procedure is used to treat herniated discs in the cervical spine. During cervical disc replacement, the surgeon makes a small incision in the front of the neck and moves soft tissues out of the way to gain access to the cervical spine. The damaged disc and any loose bone fragments are removed and replaced with an artificial disk device.
Dr. Nael Shanti of Cary Orthopaedics Spine Center is a board-certified orthopedic surgeon specializing in minimally invasive spine surgery. Dr. Shanti has expertise in advanced minimally invasive procedures including microdiscectomy, laminectomy, and lumbar fusion. If you think you might be a candidate for one of these procedures or have questions about what to expect after minimally invasive back surgery, call (919) 297-0000 to make an appointment with Dr. Shanti.