Minimally Invasive Spine Surgery (MISS)

Minimally invasive spine surgery is performed with specialized instruments and techniques that can minimize disruption to the body’s tissues.

Compared to traditional, open surgical procedures, minimally invasive procedures generally:

• use smaller incisions
• smaller scars
• require less tissue disruption
• lesser blood loss
• reduce a patient’s hospital stay
• less recovery time
• faster return to normal activities
• reduced the risk for infection
• may produce less pain and discomfort for the patient

Minimally invasive procedures are typically carried out through incisions much smaller than those used in traditional procedures. In many MISS procedures, tubular dilators are inserted into small incisions and instead of cutting the muscles and tissues, the dilators move them aside. A retractor is placed over the dilators, and the dilators are removed.

While performing these MISS, for visualization, a surgeon can use any of the following tools and techniques:

• Endoscope: A thin, flexible tube with light and a camera at the end, to visualise and magnify the images on a screen
• Fluoroscopy: This technique produces X-ray images in real time like a video X-ray.
• Microscopy: A surgical microscope provides the surgeon with a highly magnified, brightly illuminated view of the surgical area.

Minimally invasive surgery procedures include:

• Cervical microdiscectomy– a procedure that uses a microscope and microsurgical tools to remove a part of a spinal disc, compressing a spinal nerve.
• Kyphoplasty-  a procedure used to treat spinal fractures
• Lumbar Fusion – a procedure in which the surgeon removes certain portions of bone or disc and places new bone graft that will fuse with adjacent vertebrae
• Lumbar laminectomy– removing the lamina, a bone that covers the dura
• Lumbar microdiscectomy– a procedure in which a surgeon uses a microscope and microsurgical tools to remove part of a spinal disc, compressing a spinal nerve in the lumbar spine
• Percutaneous pedicle fixation – the placement of metal rods and screws into the vertebrae through the pedicles from behind
• Transforaminal interbody lumbar fusion (TLIF) – a procedure in which the surgeon removes a damaged disc and places new bone or cage.