Minimally invasive surgery (MIS) is performed with specialised instruments and techniques that minimise disruption to the body’s tissues.MIS requires a small incision and muscle dilation, gradually separating, rather than cutting and stripping the muscles that surround the spine.
MIS differs from traditional open spine surgery as it uses smaller incisions and direct access to affected spinal areas. The traditional open approach involves longer incisions, stripping large bands of muscle away from the spine. These muscles are then retracted or pulled to the side, so the surgeon can get a clear view of the vertebrae of the spine to be treated. This is avoided with MIS surgery.
To perform a minimally invasive procedure, a small incision is made over the area of the spine to be treated, and then a series of progressively larger dilators are inserted, one around the other, to gradually separate the muscles and create a “tunnel” or path through which the surgery may be performed. These dilators create channels through muscle and other tissue, down to the area of interest. Instead of cutting the muscles and tissues, the dilators move them aside. A final tube called a retractor fits over the dilators. Its function is to hold the tissues apart during surgery. Once the retractor is in place, the dilators can be removed.
A microscope is used to view the spine through the retractor. Once the bone, ligament and soft tissue compressing the nerve have been removed, the nerve is identified and decompression ensured. The retractor is then withdrawn, the skin is closed and a small dressing is applied.
Compared to traditional, open surgical procedures, minimally invasive procedures generally:
- Reduce a patient’s hospital stay post- surgery
- Require less recovery time
- Allow a faster return to normal activities
- May produce less pain and discomfort for the patient
Patients are able to mobilise the same day as the surgery is performed, and often only stay in hospital overnight. You will be discharged with pain relief medications and given a booklet outlining all postoperative instructions. Once at home you will receive a follow up phone call from the practice nurse. Postoperative appointments will be arranged for you at both the 2 and 6 week marks with the practice nurse and Dr winder respectively.
Please note that it is not uncommon to have localised back pain and stiffness for up to 6 weeks. This will generally resolve spontaneously.
Depending on the degree of nerve compression, it is also very common to have some degree of ongoing leg discomfort, as it will take time for the compressed nerve to recover. Please do not be alarmed if you have some intermittent return of the same pain in the leg as this is a normal part of the healing process.
RISKS AND COMPLICATIONS
There are risks associated with any surgery, the most common being:
- Deep vein thrombosis (DVT)
- Urinary tract infection (UTI)
- Chest infection
- Pulmonary embolism (blood clot in lungs)
- Myocardial infarction (heart attack)
- Anaesthetic complications
A full medical history including allergies, medical conditions and previous surgery is required before your surgery to help reduce the risk of complications occurring.
Some of the possible complications for spine surgery include:
- CSF leak
- Neurological injury
If you require surgery, Dr Winder will discuss all relevant risks during your consultation.