Understanding minimally invasive spine surgery

  • January 5, 2011
  • 311
                        
Minimally invasive surgery involves making a smaller incision, with the goal of a better outcome. The techniques of minimally invasive surgery continue to evolve, and a history of the practice is helpful in understanding where we are today. The concept of minimally invasive surgery on the spine probably began in the 1960’s in Europe. The concept caught hold in the United States after a physician in Las Vegas publicized results of decreased hospital stay, decrease morbidity, improved appearance, and increased functionality in patients by using microscopic techniques in surgery. Thus the operating microscope became commonplace in spine surgeries, particularly those involving decompression of lumbar cervical and cervical spinal pathology. The latest twist on this has been microscopic decompression through a small tube. This naturally led to the use of other means of magnification and lighting for improved results for spinal decompressive surgery. One method was for small, radiographically controlled imaging for decompression of spinal disk herniations. It was a small step from there to go to the operating arthroscope for different kinds of decompression, especially for the lumbar spine. The next improvement of technique was to use these initial stepping stones in order to instrument the spine and correct deformity through small, anatomy sparing, minimally invasive incisions. This has evolved into techniques for front and back surgery of the cervical, thoracic, and lumbar spine. The best rationale for this minimally invasive approach was worked out in Europe, being not so much related to the preservation of appearance near the incision but more with regard to the functional approach of sparing the connection to the muscles and leaving sensation of the spinal elements intact. By incorporating radiographic imaging of intraoperative X-ray, preoperative CT scan, and MRI scan, there is now the ability to capitalize on the geometry of the spine and the planned construct – which improves this minimally invasive approach. Computer guidance with real-time imaging has also been added to this system in order to expedite the outcome. Through the combined efforts of Wooster Community Hospital and Wooster Orthopaedic & Sports Medicine, the spinal surgery team can focus on this minimally invasive approach. Patients now have local access to microscopic decompression, arthroscopic decompression, minimally invasive fusion procedures, and minimally invasive imaging techniques for improved surgical outcomes in those cases that qualify. A smaller incision, and a better outcome. That is the goal of minimally invasive spine surgery. This concept, placed in the context of a Comprehensive Spine Center, involving neurology, pain management, spine surgery, and outpatient rehabilitation, can provide patients access to the latest techniques in a comprehensive team approach. If you have questions about minimally invasive spine surgery, contact 330-804-9712.


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