MIS is an acronym for Minimally Invasive Spine Surgery. Other terms related to MIS are minimal access spine surgery, endoscopic spine surgery, or laser spine surgery. This spine surgery is minimally invasive because surgery is performed through one or more small incisions or punctures through which tubular retractors or an endoscope is inserted. MIS helps to reduce the risk of infection and decrease pain, facilitates faster recovery, and improves back muscle function.
Tubular retractors spare cutting through muscles and soft tissues and minimize damage. Tubular retractors gently and progressively dilate and separate muscles and soft tissues to the operative field. Using specialized instruments and microscopic visualization, surgery is performed through the tube.
Endoscopes are thin tubes with a light source and camera. The endoscope is inserted through a small stab / incision and positioned. Small instruments are passed through the endoscope to the surgical site where the surgeon performs the procedure. The endoscopic set up enables the surgeon to view the surgery on a monitor.
[ Surgery is performed through small tubular MIS retractors with special internal lighting ]
[ View down a tubular retractor (18mm diameter) with internal light source ]
[ Postoperative picture after a 3-level revision with instrumentation. White dressings are the MIS incisions. The purple line shows the old open incision from initial surgery. ]
By contrast, traditional open spine surgery requires a long incision and cutting through muscles, which causes soft tissue damage and means a longer recovery.
[ Open surgery means longer incisions and muscle injury ]
MIS : -Patient Benefits
Patients with high expectations to return to work and active play find minimally invasive spine surgery offers many benefits. Even patients who are elderly, obese, or have a complex spinal problem, such as deformity or trauma may also benefit from MIS surgery.
Muscles and soft tissues are spared.
Risk of postoperative infection is decreased.
Some procedures can be performed as outpatient surgery.
Blood loss is reduced.
Patients experience less postoperative pain.
Reduced need for postoperative pain medication.
Time hospitalized is reduced.
Small incisions, cosmetically more appealing.
Recovery is faster.
Patients return to regular activities sooner.
Conditions Treated with MIS
Not so long ago, all spine surgery was performed as an open procedure. Significant advances in surgical instruments, techniques, image-guided surgery, biotechnology (i.e. bone graft), devices, and implants have made MIS safe and effective in surgical spine care.
The following spinal problems are routinely treated using MIS : -
Cervical and lumbar herniated discs.
Degenerative scoliosis.
Cervical and lumbar spinal stenosis.
Spondylolisthesis.
Other disorders treated using MIS technology include infection, trauma (i.e. spinal fracture), and tumors. MIS enables surgeons to decompress, fuse and stabilize, and correct deformity.
Conclusion
MIS procedures and techniques are safe and effective for treating many different spinal disorders. These procedures are very technical and should be performed by surgeons with training and experience in MIS techniques. Your spine surgeon will be pleased to explain how MIS may benefit you.
Minimally Invasive Spine Surgery: The Detailed Benefits
Only 10 years ago, if you had spine surgery, you could expect it to take as much as one year before you would be able return to normal activities. Minimally invasive techniques, however, are changing the face of spine surgery. What used to result in a week-long hospital stay, a year's recovery period and a large scar has been diminished to a few days, a few months and a few small scars.
How is minimally invasive spinal surgery performed?
Conventional spine surgery requires a long incision and a lengthy recovery period. Minimally invasive surgery, also known as "keyhole" surgery, uses a thin, telescope-like instrument known as an endoscope, which is inserted through small incisions. The endoscope is connected to a tiny video camera - smaller than a dime - which projects an "inside" view of the patient's body onto television screens in the operating room.
Small surgical instruments may then be passed through one or more additional half-inch incisions. Following the procedure, the small incisions are closed with sutures and covered with surgical tape. After a few months, they are barely visible.
Is this technique applicable for all forms of spinal surgery?
No. Nor is it appropriate for all patients. While the field of minimally invasive surgery is changing rapidly, three main types of minimally invasive spine surgery currently are being performed at The Cleveland Clinic : -
Spinal fusion, which often is performed on degenerative disks
Deformity corrections, such as for scoliosis
Repair of herniated disks
What are the benefits of minimally invasive spine surgery?
Typically, minimally invasive spinal surgery allows for the same outcomes as conventional spine surgery.
Benefits of minimally invasive back surgery include : -
A few tiny scars instead of one large scar.
Shorter hospital stay - a few days instead of a week.
Reduced postoperative pain.
Shorter recovery time - a few months instead of a year - and quicker return to daily activities, including work.
What can I expect after surgery?
It is important to follow your doctor's instructions after surgery. Although many people feel better after just a short while, you may need to take it easy per your doctor's recommendation.
How will I know if minimally invasive spinal surgery is appropriate for me?
Every patient is evaluated individually. Consult with your doctor about the various treatment options available.
How safe is minimally invasive spine surgery?
If performed by experts in this field, minimally invasive spine surgery is as safe as "open" spine surgery in carefully selected cases.
This information is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
Minimally Invasive Endoscopic Spinal Surgery
Endoscopic surgery refers to the use of specialized video cameras and instruments which are passed through small incisions (less than 2 cm) into the chest, abdominal or joint cavities to perform surgery.
The benefits of endoscopic surgery are threefold. Since the size of the incisions are smaller, the recovery from surgery is much quicker. There is also less pain and less damage to the surrounding tissues.
Endoscopic techniques have been used for several decades, but these were exclusively for diagnostic purposes. In the late 1970s and early 1980s, endoscopic techniques were advanced so that both a diagnosis could be made and the disease could be treated. These same endoscopic techniques used in other surgical disciplines have now been advanced to the treatment of spinal disorders. In certain cases of degenerative disc disease, scoliosis, kyphosis, spinal column tumors, infection, fractures and herniated discs, endoscopic techniques may speed recovery, minimize post-operative pain and improve the final outcome.
By using special scopes, instruments and implants the orthopaedic spinal surgeons have been able to successfully treat some spinal column disorders with less injury to surrounding healthy tissue. Essentially the operations are being performed for the same conditions, however by using endoscopic techniques the recovery is more comfortable and quicker. What once required 3 to 6 months to recover from now only requires 3 to 6 weeks.
Not every patient, however, is a candidate for endoscopic spinal surgery. To see if you are a candidate for endoscopic treatment of spinal deformity, tumor, trauma, or degenerative disease you must be fully evaluated by a surgeon knowledgeable and experienced in these techniques.
The list of of world class Spine hospitals in India is as follows : -
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