Traditional open spine surgery involves cutting and pulling the back muscles out of the way so as to expose the spine before actual surgery is performed. This is necessary in order to see the area of the spine that needs to be operated on. Sometimes more muscle is cut so that the surgeon can see the area better, especially in deeper areas. Injury to the muscles can be significant. While they usually recover, this can take a long time and causes a lot of pain as well as loss of function in the meantime. Additionally when muscle injury is severe the body repairs with scar tissue instead of muscle tissue. The function of that particular muscle may risk being lost permanently.
Minimally invasive spine surgery modifies the approach to the spine by reducing the trauma to the back muscles, while still allowing the surgeon to see and access the area of the spine that requires surgery. This is achieved with special access retractors, x-ray imaging and guidance equipment. Several small incisions are made instead of a large one, sparing all the muscles in between. With special retractors, the same size incisions are made whether the area to be operated on is deep or superficial.
The advantages of minimally invasive spine surgery are:
- much faster recovery
- shorter stay in hospital (half as long as open surgery)
- less blood loss (1/10 as open surgery)
- less pain for the patient (10 times less painkillers required in the early period after surgery)
- lower risk of infection
The long term effectiveness of the minimally invasive spine surgery is the same as the traditional approach. However the spine surgeon needs to undergo special training in order to perform the surgery well. In addition, the equipment is more expensive compared to traditional surgery and the approach cannot be applied to certain areas of the spine.