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Each year, some half a million people have surgery for lower back problems, while thousands more undergo surgical procedures for issues in other parts of the spine. Traditionally, this has meant large incisions and long recovery times. Advances in surgery, however, have made minimally-invasive procedures an attractive alternative in many cases. Today, we’ll look at the differences between traditional open surgery and minimally invasive surgery.
Open surgery, as the name suggests, involves exposing a large portion of the spine so that the surgeon has a clear view and easy access to perform whatever procedure is required.
The surgeon will make a large incision — usually about six inches long — through the skin and outer muscles of the back, then the small muscles surrounding the spine are detached and moved out of the way to further expose it. When he or she has performed the thee necessary procedure (spinal fusion, discectomy, etc.), the spinal muscles are moved back into place and the large incision is stitched up.
Open surgery results in significant trauma to muscles and soft tissue, lengthy surgery, more possibility of infection or blood loss, more post-op pain, longer recovery time, and extended hospitalization after the surgery. Open surgery also requires general anesthesia, along with its accompanying risks.
The goal of minimally invasive surgery (MIS) is to narrowly focus on the problem area and to minimize damage to muscles and other soft tissue. In MIS, several small (one inch or so) incisions are used rather than a single large one. The incisions are made near the area where work is to be done, and hollow tubes are inserted through the openings, moving muscles out of the way rather than cutting them. This reduces the amount of soft tissue trauma, and allows the surgeon to access only the necessary area rather than a large segment of the spine.
Once the tubes are in place, the surgeon will insert small, specialized surgical tools and perform the surgery, using a tiny video camera and real-time video or X-ray fluoroscopy (live X-ray) to visualize the spine and guide the surgical tools. Minimally invasive surgery is sometimes done under general anesthetic, but often also done with only regional anesthetic.
While the long-term outcomes of open and minimally invasive surgery are comparable, MIS offers a host of benefits at the time of surgery and during recovery. These include:
Different conditions may require different types of surgery, and which type is appropriate for you is a decision you and your surgeon must make together. Contact Dr. Kinchen today for a consultation, or call 360 Back and Spine Center at (682) 223-1406.