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Using cuts of only an inch or shorter in length, minimally invasive surgery accesses the spine with small tools known as retractors. These are placed into the tiny incisions to gently push away soft tissue and remove bone or disc material impinging on spinal nerves. Unlike so-called open surgery requiring large incisions, a minimally invasive approach doesn’t move, remove or alter major muscles, normal bone structures or nerve bundles.
“Even when medication, physical therapy or other nonsurgical treatments don’t do the trick to relieve longstanding back or neck pain, it might still be intimidating to consider a surgical solution,” explains Dr. Liu, who is fellowship-trained in minimally invasive spine surgery. “That’s why it’s especially crucial to cut through the myths and know the truths about minimally invasive options.”
Top misperceptions
What are the most pervasive myths about MISS? Dr. Liu lays out the top 5 and also explains the realities:
Myth #1: Minimally invasive spine surgery is still experimental.
Truth: Far from it. MISS has been successfully in use since the 1990s, with continuing technological advances only increasing its reach. Highly technical, minimally invasive surgery requires surgeons and operating room staff to be specially trained. On top of that, the equipment needed for MISS procedures can be costly, meaning some smaller hospitals can’t provide it. Ask your doctor if MISS is an option where you’re located.
Myth #2: Only a few spine conditions can be addressed using minimally invasive surgery.
Truth: Since its early days three decades ago, MISS use has expanded enormously for those whose back or neck pain has persisted for 6 to 12 months or longer despite conservative treatments. It can tackle conditions ranging from spinal stenosis (a narrowing of the spinal canal) to sciatica, herniated discs, and spondylolisthesis, when one bony vertebra slips out of place onto the bone below it. “All of these conditions can be pinpointed with various diagnostic and imaging tests that can tell surgeons exactly where to operate for the best results,” Dr. Liu says.
Myth #3: A long recovery is still necessary even with minimally invasive spine surgery.
Truth: You’ll recover faster than you imagine – starting with the procedure itself, since it’s usually done on an outpatient basis. “Many people can get right up and walk right after minimally invasive spine surgery with only minimal pain, and most go home within hours,” Dr. Liu says. “You can usually also go back to work within a week or two, and some people are doing all their prior activities within 6 weeks.”
Myth #4: Undergoing minimally invasive spine surgery means I won’t need physical therapy.
Truth: While MISS can free us from many of the potential pitfalls of traditional surgery, patients must still be willing to make the effort toward as full a recovery as possible. This may include physical therapy to strengthen muscles surrounding the spine and improve flexibility, a regimen often introduced 2 to 6 weeks after surgery. “Whether physical therapy is necessary or not depends on each patient’s individual circumstances,” Dr. Liu explains. “Many find physical therapy speeds their overall recovery and makes them feel better even more quickly.”
Myth #5: MISS offers no benefits compared to open surgery.
Truth: While any type of surgery poses risks, minimally invasive spine surgery offers many advantages compared to traditional operations. Because incisions are small and trauma to surrounding tissues is minimized, you can expect less pain and blood loss with MISS and a much quicker recuperation. “There’s also a lower risk of needing a blood transfusion as well as a better cosmetic result with a minimally invasive approach,” Dr. Liu says. “You’ll stand a lower risk of infection and should bounce back much faster in the days and weeks after surgery than if you underwent a procedure using long incisions.”
Atlantic Spine Center is a nationally recognized leader for endoscopic spine surgery with several locations in NJ and NYC. www.atlanticspinecenter.com, www.atlanticspinecenter.nyc
Kaixuan Liu, MD, is a board-certified physician with Atlantic Spine Center. He is fellowship-trained in minimally invasive spine surgery.
