Spine Surgery and Advancement of Minimally Invasive Techniques
Spine Surgery and Advancement of Minimally Invasive Techniques
Posted on 23. Mar, 2011 by Dr. Joseph Maroon in Concussion / Brain and Spine, Neurosurgery
Over the last decade there have been tremendous advances in neurosurgery and especially in spine surgery. One of the areas of improvement is how surgeons can now approach to the spine by using ever smaller incisions. This advancement is called minimally-invasive spine surgery and can mean less tissue trauma. This approach can allow for a shorter hospital stay and faster post-operative recovery. This is especially important for those who need to return to work more quickly after a major operation.
A person’s age, overall health, symptoms, and the nature of their disease are all important factors to consider when determining this treatment option, but many people are now qualifying for this less traumatic approach. Minimally invasive procedures to the spine differ from not only by improved surgical recovery and less tissue trauma than traditional surgical approaches, but also few post operative complications. In a study to be published in April 2011, the authors reviewed data on infection rates from over 100,000 spine surgical procedures and found that infections rates were significantly lower in minimally invasive spine procedures compared to traditional approaches.
So how is minimally invasive surgery different? Perhaps the biggest advancement came about 2 decades ago with the invention and perfection of the use of the operating room microscope. By visually enlarging what was seen the surgeon could use a smaller incision to get to the same location to do their work. The next big advance was a by-product of both NASA and military technology that could allow for three dimensional targeting. Being able to local a spot within the body, with advanced imaging MRI and CT scan, before cutting any tissue allows for placement of tubes or ports to be exactly targeted over the abnormal section of the spine. This technology coupled with the operating room microscope or an advance endoscope video camera means the modern spine surgery OR is more like a space shuttle bay.
Although traditional open procedures are still required for many cases, the need for dissecting large sections of the back muscles away from their spinal attachments is often not required in most complex cases. Minimally invasive surgery is directly able to reduce significant post operative pain and tissue scarring, which can delay return to full activity.
The goals of minimally-invasive techniques include:
- reduced surgical complications
- reduced surgical blood loss
- reduced use of post-op pain medicines
- reduced length of hospital stay (outpatient surgery)
- and increased speed of return to daily activities
Minimally-Invasive Ports
This latest technique allows the surgeon to approach the lumbar spine without having to cut muscle tissue. By “splitting” the muscle to then visualize the spine, the patient can have a much smaller incision and less trauma to healthy tissue, often resulting in a quicker recovery.
Artificial Cervical Disc
The era of artificial spine discs is now here. The latest include both lumbar and cervical spine artificial discs. These are intended to lead to fewer repeat surgeries and earlier recovery. This advancement in technology will allow the spine to maintain mobility and can reduce the potential degeneration of other spine levels, which can occur in some patients with traditional spine fusion.
Spine Fusion
We have now entered an era where large spinal fusion surgery is not always consider as the first and base treatment option. Advanced minimally-invasive spine techniques for complex spine surgery that may also include fusion of the spine. Today, unlike years ago when a person was required to lay in bed for weeks at a time after spine fusion, often patients can begin walking the same night of surgery and home within one or two days after surgery because of their significant improvement.
Reference
Rates of Infection After Spine Surgery Based on 108,419 Procedures: A Report from the Scoliosis Research Society Morbidity and Mortality Committee Spine: 01 April 2011 – Volume 36 – Issue 7 – p 556–563
About the author
Joseph Maroon, MD, is a world-renowned, board-certified neurosurgeon, who has been honored as one of America’s Best Neurosurgeons for 8 consecutive years. He has published over 250 scientific papers, 8 books, and 40 book chapters. His other research has focused on the prevention and treatment of injuries and disease. In his most recently published book, The Longevity Factor: How Resveratrol and Red Wine can Activate Genes for a Longer and Healthier Life, Dr. Maroon relates the new science of genetic activation and the ability of food choices, supplements like resveratrol and lifestyle choices to activate human genes, to better health and disease prevention. He has also authored Fish Oil: The Natural Anti-inflammatory, which discusses the wide range of conditions for which omega-3 fish oil has been found helpful.
As a world famous neurosurgeon, he has been honored by various national and international neurological societies for his contributions to neurosurgery. Despite his busy professional schedule, he is a devoted athlete, completing 50 Olympic distance triathlons since 1980, and was inducted in Lou Holtz Upper Ohio Valley Hall of Fame in 1999 for his athletics and sports medicine.
