Minimally Invasive Spine Surgeries (MIS Spine Surgery) or key-hole spine surgeries are spine surgery procedures done with minimal soft tissue destruction. The main aims of the surgery, i.e. decompression, instrumentation and fusion are achieved with a small skin incision. Specialized retractor system are used for decompression surgeries. Specialized equipment are used for MIS spine surgery to allow instrumentation through tiny holes in the skin. A microscope/ endoscope is usually used for these surgeries.
Advantages of Minimally Invasive Spine Surgery:
- Safe and precise surgery due to better magnification and illumination of the surgical field.
- Less soft-tissue and muscle damage.
- Cosmetic scar due to small skin incision/s.
- Minimal blood loss during the surgery.
- Less chances of infection.
- Minimal post-operative pain
- Less requirement for pain medicines.
- Faster mobilization and rehabilitation.
- Short hospital stay.
- Early return to work.
Disadvantages/ Limitation of Minimally Invasive Spine Surgery:
- Requires special expertise to perform,
- Requires specialized OT setup and surgical assistance,
- Requires specialized instruments, microscope, endoscope etc.,
- May not be suitable for certain pathologies, e.g. severe spinal stenosis, high grade spondylolisthesis etc.
- Not suitable for multilevel pathologies.
Type of Minimally Invasive Spine Surgeries:
Most commonly done minimally invasive spine surgeries are microdiscectomy, MIS TLIF and anterior cervical discectomy & fusion. However, almost all types of spine surgeries can be performed by minimally invasive spine surgery techniques.
- Anterior cervical spine decompression and fusion surgeries (ACDF/ ACCF),
- Posterior cervical spine decompression and fusion surgeries,
- Posterior cervical micro-foraminotomy,
- Anterior thoracic spine surgeries,
- Posterior thoracic spine decompression and instrumentation surgeries,
- Anterior lumbar decompression and fusion surgeries (ALIF/ XLIF/ OLIF),
- Posterior lumbar decompression and fusion surgeries (MIS TLIF),
- Sacro-iliac fusion surgeries,
- Kyphoplasty/ Vertebroplasty.
Not all surgeries can be treated by a minimally invasive spine surgery procedure. However, principles of MIS spine surgery can be applied to traditional surgeries also as much as possible. In fact, recovery pattern for most of the traditional spine surgeries is not much different when compared to MIS surgeries. This is due to advanced surgical techniques and equipment. It is very important to choose correct procedure which will give maximum benefit with minimal side effect for a particular pathology.