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Minimally
Invasive Surgery |
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Minimally
Invasive Surgery (MIS) is one of the most significant
new advances in treating back pain.
In cases where spine surgery was called for, the traditional
approach required large incisions and stripping of the
muscles from the bony elements of the spine. During longer
procedures, vital nerves and muscles might be denied adequate
blood supply.
Typically, the recovery period was long and delayed the
patient from experiencing the full benefit of the surgery.
In some cases, the loss of muscle mass and back stability
from the procedure itself risked a disabling outcome that
the surgery itself was intended to cure.
MIS, also called Minimal Access Surgery (MAS), involves
performing spine surgeries through small incisions, typically
two or more small incisions in place of one large incision.
The goal is to limit damage to nerves and muscles while
approaching and operating on the spine. By utilizing either
an endoscopic camera or magnification (loupes or microscopes)
through a small tube to visualize a small portion of the
spine, the surgeon utilizing MIS seeks to complete the
procedure with the least surgical trauma possible.
The results have been exciting. Medical studies indicate
that patients respond with shorter hospital stays, reduced
post-operative pain, earlier return to work and improved
satisfaction. Long-term benefits are believed to include
reduced scarring, improved body mechanics and reduced
need for re-operation for spinal instability.
Two issues are currently inhibiting the broad adoption
of MIS techniques for spine surgery. The first is simply
the challenge of training and education. Performing MIS
techniques involves practices that are fundamentally different
from traditional practices. For example, the surgeon is
required to use either a 2D monitor or a small tube resulting
in a change in the visualization of the spine. Different
instruments and implants are also required. In order to
perform MIS techniques, surgeons must undergo specialized
hands-on training.
Providing training to surgeons on MIS techniques is one
of the primary goals of the National Spine Foundation.
The other challenge for a broader adoption of MIS is the
lack of necessary instruments and implants for some spine
surgery procedures. With reduced access, new screws, rods
and cages are required. Many simply aren’t available
yet for some procedures, requiring surgeons trained in
MIS to perform traditional procedures. The National Spine
Foundation plans to pursue research on instruments and
implants necessary to expand the usage of MIS. |
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