Minimally invasive spine surgery or MISS is a safe and effective technique used as an alternative to traditional open surgical procedures performed to treat patients suffering from spinal disorders. This type of surgery is performed is to achieve high outcomes while stabilising the vertebral bones and spinal joints and/or relieve the pressure being applied to the spinal nerves. If not treated, it may result in conditions such as spinal instability, bone spurs, herniated discs, scoliosis or spinal tumours.

The major indicators that highlight the need for spine surgery are:

• Loss of flexibility and movement 
• Chronic pain in the back, legs, neck and shoulder
• Experiencing utter discomfort while lying down or sitting in the same position 
• Visible deformity in the spine
• Inability to perform various daily activities 
• Stiffness in the spine

Some of the major conditions we treat under spine surgery include:

• Spondylolisthesis
• Degenerative Disc Disease
• Disc Herniation
• Spinal Compression Fractures
• Spinal Cord Injury and Spinal Trauma
• Spinal Stenosis
• Scoliosis
• Kyphosis
• Meningioma
• Hemangioma
• Hemangioblastoma
• Neurofibroma
• Metastatic Tumours
• Schwannoma
• Chiari Malformation
• Vascular Malformation
• Basilar Invagination

Minimally invasive spine surgery is the most advanced surgical process that is the last resort of treatment for people suffering from severe spinal disorders when all other treatment options fail. You are a candidate for minimally invasive spine surgery if:

• Non-surgical treatments do not effectively reduce symptoms of a spinal disorder. These treatments include 
  • Medications
  • Physical therapy 
  • Spinal injections

A patient must talk to a doctor or spine specialist about your pain and symptoms in detail along with the outcomes of different treatments tried by the patient. After evaluating all the considerations your doctor may advise you to undergo surgical treatment to treat back or neck pain.

Minimally invasive spine surgery (MISS), also called less invasive spine surgery is a surgical process that requires a small incision for performing the surgery. 

Preoperative Details

Before proceeding with the surgery the doctors have to make sure that the patient is fit for the procedure. This is done by performing a series of tests and screening process. The patient might be prescribed certain medications, a week or two before the surgery, to avoid any sort of infection during or after the surgery. 

A patient will receive general anaesthesia before moving to the operation theatre and will sleep through the surgical procedure.
Operative Details

• Step 1: The doctor will make a few small incisions at the affected site.
• Step 2: A thin telescope-like instrument, called an endoscope is inserted through small incisions in the body. It has a tiny video camera – smaller than a dime attached to its top, which projects the inside view of the patient’s body on a monitor. These images help the doctor to perform complex operations easily.
• Step 3: The doctor then passes small surgical instruments or robotic arms (during robotic-assisted surgery) through these incisions to perform the surgery by using the best X-ray views of the anatomy of the spine. 
• Step 4: The doctor closes the incisions with sutures and covers them with surgical tape.

Postoperative Details

After the operation, the patient has to stay in the hospital for a day or two for monitoring purposes. A doctor might prescribe a patient to take physiotherapy sessions in order to have a fast recovery.

At the unit we aim for helping patients suffering from chronic spinal disorders that can lead to permanent deformity and prevent you from living a normal life. Spine surgeries can be of different types:

• Spinal fusion: It is one of the most common spine surgeries that are used to join two or more vertebrae. The surgery involves the use of metallic wires, screws, pins, rods and plates. The various different type of procedures such as open surgery, minimally-invasive surgery, endoscopic, laser surgery etc.
• Discectomy or Microdiscectomy: It is another common spinal surgery that is used to treat patients suffering from herniated inter-vertebral discs. It helps to relieve the pressure on the nerve. 
• Microsurgical: In this type of surgery surgeons use a microscope to remove the damaged portion of the disc. It requires small incision usually less than an inch over the spinal canal.
• Percutaneous Stitches: This type of surgery involves the removal of the disc portion using an endoscopic surgery by making a small incision at the back of the knee.
• Laser Surgery: The procedure involves the removal of a small bone from the spine through laser, in order to get rid of nerve root compression which can lead to chronic pain in the back or lower limbs. 
• Spinal Decompression: It is the standard procedure of providing relief from compressed nerves by decompressing it using Minimally Invasive key-hole approach (microscopic or endoscopic).
• Vertebroplasty/Kyphoplasty: These types of procedures are performed to relieve the patient from the chronic pain and other problems associated with compression fractures of the vertebrae. These procedures involve the injection of cement through a needle into the vertebrae. The goal is to reduce deformity by restoring height to the crumbled vertebra and provides immediate relief from pain.

MIS has many benefits to offer over traditional surgery process

• Small Incisions
• Less pain
• Low risk of infection
• Lesser disruption of muscles and tissues
• Short hospital stay
• Quick recovery time
• Less scarring

Nowadays, minimally invasive surgeries are becoming more and more common than traditional open surgeries. The surgeons perform the surgery without making large incisions and use small tools, cameras and lights that fit through those incisions using the Robotic surgery technique. This gives them more close control over the surgical process, thereby, resulting in fast after surgery recovery outcomes. 

The important precautionary measures one must consider after the surgery are: 

• Avoid sitting in the same position for longer durations 
• Avoid heavy weight lifting. 
• Maintain a proper posture while sitting and sleeping 
• Do not perform rigorous exercises. 
• Take all the medications prescribed by the doctors
• Start physical therapy as soon as possible 
• Do not indulge in sexual activities. 
• Avoid forward bending
• Use western toilet system

Certain risk factors associated with spine surgery include:

• Bleeding
• Infection
• Clot formation 
• Post-operative neuro-deficit worsening
• Recurrence of symptoms
• Post-operative neuropathic pain
• Delayed recovery

However, at BLK-Max Hospital we strive to provide each patient with the most comprehensive care and therefore, it is always a doctor who decided the type of surgery a patient will undergo after completely examining the medical condition of the patient.