Thoughts of having spine surgery bring in a lot of fear for the unknown. Spine surgeries are traditionally considered to be associated with lots of pain, slow recovery, poor outcome and prolonged bed rest. So naturally, facing the possibility of spine surgery can be extremely scary for an individual. This is especially true for a country like India, where awareness levels about health and disease are not high. Spine surgeries are associated with a lot of misconceptions.
Over the last three decades, the outcomes after spine surgery have improved vastly. This is a lot because of our enhanced understanding of spinal pathologies and spine dynamics. The spine surgical techniques have become more refined. The use of operating microscopes to give magnification and illumination and the use of an endoscope have made Keyhole spine surgeries or Minimally invasive spine surgeries possible.
As the name implies, minimally invasive spine surgeries cause minimal disruption of the normal tissues. They are very precise in targeting the affected part of the spine. Keyhole spine surgery utilizes a “Keyhole” like small incision. The small incision and minimal disruption of normal tissues have to lead to a remarkable improvement in the outcomes of spine surgeries. The key benefits of Keyhole or Minimally invasive spine surgery are
- Less pain after surgery
- Minimal blood loss
- Shorter recovery periods
- Faster ambulation
- Less scar formation around nerves
- Better outcomes
The results after spine surgery have improved so much that it is now possible to walk within a couple of hours after spine surgery. Gone are the days when prolonged bed rest was required after spine surgery. In fact, it is important to start walking as soon as possible. Ambulation helps in improving blood flow in the legs, which reduces complications associated with rest. Certain routinely encountered conditions like disc herniations, lumbar canal stenosis and tumours like neurofibromas can be operated using minimally invasive techniques very easily.
Lumbar disc surgery
Microdiscectomy or microscopic removal of the herniated disc has become a gold standard operative technique for lumbar disc herniations. The herniated discs causing pressure on the nerve root can be removed using a small incision with minimal blood loss and post-operative pain. This surgery can be done as a daycare procedure and patients can return home without spending any night at the hospital. Only in some patients, an overnight stay would be required. The patient can start walking within a couple of hours after the surgery.
Lumbar canal stenosis or Spinal canal stenosis
Traditionally the surgery for lumbar canal stenosis involved the removal of the lamina of the vertebra to remove pressure from the nerves. This caused a lot of disruption of normal tissues and blood loss.
Now, this condition is tackled in a minimally invasive fashion to achieve targeted decompression of nerves. The recovery is much faster than open techniques and walking is possible within a few hours after surgery.
Spinal fixations with screws and rods for fractures of the spine are also possible in a minimally invasive fashion using percutaneous screws. This is a great development and open spinal fixations are considered among some of the most painful procedures. Minimally invasive techniques have made fixations less painful and help in moving patients out of bed early after surgery.
Spinal tumors like Neurofibromas and Meningiomas
Certain tumours in spine-like Neurofibromas and Meningiomas can be treated with minimal disruption of normal tissues. The post-op pain is significantly less and recovery is very fast in these surgeries. Walking is possible, the same day after surgery in most cases.
Vertebroplasty and Kyphoplasty
These procedures are done in patients with painful fractures in weak bones. These fractures are seen in elderly patients and prolonged bed rest is not an option. In these procedures, cement is placed in the fractured bone using small needles to reduce pain and improve mobility of the patient.
Minimally invasive or Keyhole spine surgery is safe and effective. The benefits of this technique far outweigh the risks. It can help restore the quality of patients without postoperative pain. No need to be afraid of spine surgery anymore, reach out and enquire about Minimally invasive spine surgery.
Dr. Harnarayan Singh | Senior Consultant – Neurosurgery | Narayana Superspeciality Hospital, Gurugram