Minimally invasive spine surgery (MISS) is a way of performing spinal surgery on the bones of your back by utilising significantly smaller cuts and incisions than the traditional open spinal surgery. The traditional open surgery uses a larger incision down the back thereby resulting in significant collateral damage in the form of soft tissue and muscle trauma, longer hospitalisation and increased rehabilitation and recovery time.
MISS can be utilised for numerous spinal surgeries including lumbar discectomy, laminectomy, and spinal fusion. During MISS, the spine surgeon creates a channel to the problem area of the spine utilising tubular retractors. It gently moves aside the muscle and soft tissues, thereby enabling the surgeon to put small instruments through the channel.
In the last couple of decades, even the techniques for performing MISS have rapidly evolved, and the size of incisions have significantly reduced. Endoscopic spine surgery (ESS) may be regarded as the eventual method of MISS. In this technique, specialised video cameras known as ‘Endoscope’ and instruments to remove the herniated disc through very small incisions. A camera is inserted through a very small portal (akin to a keyhole) to the problem area of the spine. During your procedure, fluoroscopes (X-ray machines) are used to provide the best views of your spine. The camera projects the images onto a TV monitor. Extremely small and highly specialised instruments are inserted through the portal to deal with the spine problem direct visualization. The approach is usually made through the back, and sometimes through the chest or abdomen, to gain access to the spine to perform the surgery. ESS can even be performed in local anaesthesia thereby reducing the risks of complications arising out of general anaesthesia.
MISS and ESS can be used to treat a variety of spinal disorders and conditions such as herniated discs (Slip Disc), sciatica, scoliosis or other spinal deformities, spinal fractures, spinal infections and spinal tumours. With Minimally Invasive Spine Surgery and Endoscopic Spine Surgery, most patients usually return home either the same day or at the most within two days after surgery.
The advantages of MISS and ESS endoscopic procedures when compared to the traditional procedures include small incision and minimal scar tissue formation, improved cosmesis, faster rehabilitation, less bleeding, lesser collateral damage, reduced pain and hospital stay, reduced risk of infection, faster return to normal life.
Minimally Invasive Spine Surgery and Endoscopic Spine Surgery are highly advanced spine surgery techniques that aim to alleviate spinal problems without causing too much collateral damage. The surgeons performing these need specialised training and experience to have the best outcomes and minimise risks and complications. It is a boon especially for children as they can resume their school earlier and not lose out on academic activities.