September 3, 2024

Ask the Experts: How to Determine if You’re a Candidate for Minimally Invasive Spine Surgery

MISS offers advantages over traditional open surgery, including smaller incisions, less muscle and tissue damage, reduced blood loss, shorter hospital stays, faster recovery times, and less postoperative pain, but it is essential to recognize that not all spine conditions can be treated with this technique.

To determine if you are a candidate for minimally invasive spine surgery (MISS), consider several key factors: first, the procedure is typically recommended after conservative treatments like medications, physical therapy, and injections have failed to provide adequate relief. An accurate diagnosis is crucial, as MISS can address specific spinal conditions such as degenerative disc disease, herniated discs, lumbar spinal stenosis, spinal deformities, infections, instability, compression fractures, and tumors. Your surgeon will assess the accessibility of your spine through small surgical corridors, evaluate your overall health and medical history, and review imaging tests like MRIs or CT scans to confirm eligibility. It is also important to have realistic expectations about the potential outcomes of the surgery.

Consulting with a specialist, such as Dr. K. Brandon Strenge, who is experienced in MISS techniques, will provide a thorough evaluation of your individual case, and help determine the most appropriate treatment approach.

What Is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery (MISS) is an advanced surgical technique that allows surgeons to access and treat spinal conditions through smaller incisions, resulting in less damage to surrounding muscles and tissues compared to traditional open surgery. MISS uses specialized instruments and imaging technology to access the spine through small incisions, typically less than an inch long. The surgeon inserts a small metal tube or endoscope through these incisions, creating a narrow corridor to the surgical site. This approach allows the surgeon to visualize and treat the affected area of the spine while minimizing disruption to surrounding muscles and soft tissues.

Some common minimally invasive spine procedures performed by specialists like Dr. Strenge include:

  • Microdiscectomy for herniated discs
  • Laminectomy for spinal stenosis
  • Spinal fusion for degenerative disc disease or spondylolisthesis
  • Vertebroplasty or kyphoplasty for vertebral compression fractures
  • Endoscopic discectomy for disc herniations
  • Minimally invasive decompression for nerve root compression
  • Percutaneous pedicle screw fixation for spinal instability

MISS offers several advantages over traditional open surgery, including smaller incisions, less blood loss, reduced postoperative pain, shorter hospital stays, and faster recovery times. However, not all spinal conditions can be treated with MISS, and the suitability of this approach depends on various factors specific to each patient’s case. It is important to note that while MISS techniques are less invasive, they still carry some risks and require careful patient selection. A thorough evaluation by an experienced spine surgeon like Dr. Strenge is necessary to determine if MISS is the most appropriate treatment option for a given condition.

How To Decide If a Minimally Invasive Procedure is Right For You

Demographics of the Ideal Candidate

  • Age: Typically younger patients are preferred, as older patients may face higher risks and longer recovery times.
  • Health: Candidates should be in good overall health without significant comorbidities that could complicate surgery and recovery.
  • Weight: Ideal candidates are not obese, as excess weight can increase surgical risks and complicate recovery.

Symptoms of the Ideal Candidate

  • Persistent Back Pain: Severe back pain that disrupts daily activities and has not responded to conservative treatments like medications or physical therapy.
  • Specific Spinal Conditions: Conditions such as herniated discs, degenerative disc disease, spinal stenosis, scoliosis, spondylosis, compression fractures, pinched nerves, and spondylolisthesis.

Medical History of the Ideal Candidate

  • Failed Conservative Treatments: Candidates should have tried and failed non-surgical treatments, including medications, physical therapy, and injections.
  • No Significant Epidural Scarring: Previous surgeries that resulted in significant scarring may disqualify a patient from being a candidate for MISS.
  • Non-Smoking: Smoking can increase risks such as blood clotting and impair healing, so non-smokers or those willing to quit are ideal.

Other Considerations

  • Precise Diagnosis: The exact location and cause of the spinal issue must be identifiable through imaging tests like MRIs or CT scans, allowing for targeted intervention.
  • Realistic Expectations: Candidates should have a clear understanding of the potential outcomes and limitations of the surgery.
  • Post-Surgery Recovery: Candidates should be prepared for a recovery period that includes physical therapy and adherence to postoperative care instructions to ensure the best outcomes.

Minimally invasive spine surgery offers numerous benefits such as smaller incisions, reduced blood loss, shorter hospital stays, faster recovery times, and less postoperative pain. However, not all patients are suitable candidates, and a thorough evaluation by a specialized spine surgeon, like Dr. Strenge, is essential to determine the most appropriate treatment approach for each individual case.

Questions To Ask Your Medical Provider About Minimally Invasive Spine Surgery

When considering minimally invasive spine surgery, here are some important questions to ask your medical provider:

  • Am I a good candidate for minimally invasive spine surgery? Why or why not?
  • What specific minimally invasive procedure do you recommend for my condition?
  • What are the potential benefits of this minimally invasive approach compared to traditional open surgery in my case?
  • What are the risks and potential complications associated with this procedure?
  • Approximately how many of these procedures have you performed? What is your success rate?
  • What is the expected recovery time and process after surgery?
  • Will I need physical therapy after the procedure? For how long?
  • What restrictions will I have after surgery and for how long?
  • What is the long-term outlook and success rate for this procedure?
  • Are there any alternatives to surgery that I should consider first?
  • How will this procedure affect my mobility and daily activities in the short-term and long-term?
  • What type of pain management will be used after the procedure?
  • Will I need any special equipment or assistance at home during recovery?
  • What follow-up care will be required after surgery?
  • What signs or symptoms should I watch for that may indicate a problem after surgery?

Asking these questions will help you better understand the procedure, set appropriate expectations, and make an informed decision about whether minimally invasive spine surgery is right for you. Be sure to discuss any concerns or questions you have with your surgeon before proceeding.

Benefits of Minimally Invasive Spine Surgery Compared to Traditional Methods

While not all spinal conditions can be treated with minimally invasive methods, when appropriate, these techniques offer significant advantages over traditional open surgery in terms of patient recovery and outcomes. The key benefits of minimally invasive spine surgery compared to traditional open surgery methods include:

  1. Smaller incisions: Minimally invasive techniques use very small incisions, typically less than an inch long, compared to the large incisions required for open surgery. This results in less tissue damage and scarring.
  2. Less muscle and tissue damage: Minimally invasive approaches avoid cutting or pulling muscles away from the spine, reducing trauma to surrounding tissues.
  3. Reduced blood loss: The smaller incisions and less tissue disruption lead to less blood loss during surgery.
  4. Faster recovery time: Patients typically experience quicker recovery and can return to normal activities sooner due to the reduced tissue damage.
  5. Less postoperative pain: Smaller incisions and less tissue trauma result in reduced pain after surgery.
  6. Shorter hospital stays: Many minimally invasive procedures can be done on an outpatient basis or with shorter hospital stays compared to open surgery.
  7. Lower risk of complications: There’s a decreased risk of surgical site infections and other complications associated with large incisions.
  8. Reduced need for pain medication: Patients often require less pain medication during recovery.
  9. Better cosmetic results: The smaller incisions result in minimal scarring compared to traditional open surgery.
  10. Potentially better outcomes for certain patients: Minimally invasive techniques may be particularly beneficial for obese patients, the elderly, and those with chronic pain conditions.

Risks and Potential Complications to Consider

While minimally invasive spine surgery (MISS) offers numerous benefits, it also carries certain risks and potential complications. The risks are similar to open spinal surgery procedures. Before MISS, patients should consider:

  • Infection: As with any surgery, there is a risk of infection at the surgical site, which can range from mild to severe and may require additional treatment.
  • Excessive Bleeding: Although less common in MISS than in traditional surgery, there is still a risk of significant bleeding during or after the procedure.
  • Nerve Damage: Surgery near the spine always carries the risk of damaging nerves, which can result in pain, weakness, or numbness.
  • Blood Clots: Prolonged immobility during and after surgery can increase the risk of developing blood clots, which can lead to serious complications like pulmonary embolism.
  • Anesthesia Risks: General anesthesia poses risks such as allergic reactions, changes in heart rate or blood pressure, and other complications.
  • Instrumentation Failure: Hardware used to stabilize the spine, such as screws or rods, may fail or become dislodged, potentially requiring revision surgery.
  • Failed Surgery: There is a possibility that the surgery may not achieve the desired outcome, leading to persistent pain or other symptoms that may necessitate further treatment.
  • Dural Tear and Spinal Fluid Leak: A tear in the dura mater (the tissue covering the spinal cord) can occur, leading to spinal fluid leaks, which may cause headaches and other complications.
  • Pain at the Graft Site: If a bone graft is used, there may be pain at the site where the graft was taken.
  • Complications from Pre-Existing Conditions: Patients with conditions such as diabetes, obesity, or heart disease may face increased risks during and after surgery.
  • Nonunion or Pseudarthrosis: In spinal fusion procedures, there is a risk that the bones may not fuse properly, leading to continued instability and pain.
  • Continued Pain, Numbness, or Weakness: Some symptoms may persist after surgery, and in some cases, the surgery may not fully alleviate the patient’s pain or neurological deficits.

One potential risk of MISS is that your surgeon may need to convert the surgery to an open procedure if, during the surgery complications arise.

It is crucial for patients to discuss these risks with their healthcare provider and weigh them against the potential benefits of the procedure. Choosing an experienced surgical team can help mitigate some of these risks and improve the likelihood of a successful outcome.

Discover Relief Through Minimally Invasive Spine Surgery with Strenge Spine

Imagine waking up without the persistent, debilitating back pain that has been a constant companion for months, if not years. Minimally invasive spine surgery (MISS) offers a path to relief, allowing you to return to your daily activities with minimal disruption. MISS involves small incisions and specialized instruments, resulting in less muscle and tissue damage, reduced blood loss, and faster recovery times compared to traditional open surgery. Patients often experience less postoperative pain and can return home sooner, enjoying a quicker return to their normal lives.

Key Points Discussed

  • Minimally Invasive Techniques: MISS uses small incisions and advanced tools to minimize damage to muscles and tissues, leading to faster recovery and less pain.
  • Common Procedures: Dr. Strenge specializes in various MISS procedures, such as microdiscectomy, laminectomy, spinal fusion, and more.
  • Benefits: Reduced risk of complications, decreased muscle damage, faster recovery, less postoperative pain, and superior cosmetic results.
  • Ideal Candidates: Patients who have not found relief through conservative treatments, have specific spinal conditions, and are in good overall health.

Consult With a Specialist

To determine if minimally invasive spine surgery is right for you, it’s crucial to consult with a specialist like Dr. K. Brandon Strenge. Dr. Strenge is a fellowship-trained orthopedic spine surgeon with extensive experience in MISS and motion-preserving procedures. He can provide personalized advice and develop a treatment plan tailored to your specific needs.

For more information or to schedule a consultation, visit the Strenge Spine Center’s website or contact their office directly at info@strengespine.com or by calling (270) 228-3973. By taking this step, you can explore the possibility of finding lasting relief from your spinal pain through minimally invasive techniques.

FREQUENTLY ASKED QUESTIONS

Who is not a candidate for minimally invasive spine surgery?

Not everyone is a suitable candidate for minimally invasive spine surgery (MISS). Here are some factors that may disqualify a patient from being a candidate for MISS:

  • Certain spine infections and malignancies: Some spine infections and cancers cannot be treated with a minimally invasive approach.
  • Complex spinal deformities: Severe or complex spinal deformities may require traditional open surgery for proper correction.
  • Extensive spinal instability: Cases requiring extensive stabilization of the spine may not be suitable for minimally invasive techniques.
  • Significant epidural scarring: Patients with extensive scarring from previous surgeries may not be good candidates for MISS.
  • Obesity: While some sources suggest MISS can be beneficial for obese patients, extreme obesity may complicate the procedure and increase risks.
  • Certain medical conditions: Patients with specific health issues that increase surgical risks may not be suitable for MISS.
  • Need for extensive spinal reconstruction: Some complex cases requiring extensive reconstruction may necessitate traditional open surgery.
  • Inadequate imaging or unclear diagnosis: If the exact source of the problem cannot be pinpointed through imaging, MISS may not be appropriate.
  • Previous failed minimally invasive procedures: In some cases, if a previous MISS attempt was unsuccessful, open surgery might be recommended.

It is important to note that the suitability for MISS is determined on a case-by-case basis. A thorough evaluation by a spine specialist is necessary to determine if a patient is a good candidate for minimally invasive spine surgery or if traditional open surgery would be more appropriate.

What is the success rate of minimally invasive back surgery?

Success rates after minimally invasive back surgery are generally quite good, i.e., higher than 90%. Success rates vary by the type of minimally invasive back surgery that is performed. Because people who are candidates for MISS tend to be younger, healthier, and have less complex medical issues, success rates tend to be even higher than for open surgery.

How long does it take to recover from a minimally invasive spine surgery?

Minimally invasive spine surgery (MISS) typically offers a significantly shorter recovery time compared to traditional open spine surgery, with an average recovery period of about 6 weeks. However, the exact duration can vary depending on factors such as the specific procedure performed, the patient's overall health, age, and adherence to post-operative instructions. Many patients can return home on the same day or within 1-2 days after surgery, and most can resume normal activities after approximately 6 months. Physical therapy often begins soon after surgery and continues at home as part of the recovery process. While initial recovery takes about 6 weeks, full healing and return to all normal activities may take up to 6 months. Patients typically experience less postoperative pain and can begin physical therapy sooner than with open surgery, contributing to a faster overall recovery. It's crucial for patients to follow their surgeon's specific instructions for optimal outcomes, as individual recovery times can vary based on personal circumstances.

How long does a minimally invasive procedure take?

The duration of a minimally invasive spine surgery procedure varies depending on the specific type of surgery and the complexity of the patient's condition. Generally, these procedures take less time than traditional open spine surgeries. For instance, a microdiscectomy or laminectomy might take approximately 1 to 2 hours to complete, whereas more complex procedures like spinal fusion take longer. The reduced operating time is one of the benefits of minimally invasive techniques, as they involve smaller incisions and less disruption to surrounding tissues, allowing for a more efficient surgical process.

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