Minimally invasive spine surgery (MISS) is sometimes called less invasive spine surgery, here the surgeon use specialized instruments to access the spine through small incisions. This technique utilizes modern technology to reduce tissue trauma, bleeding, hospital stay and recovery by minimizing the size of the incision.
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Signs and Symptoms
- Lower back and neck pain
- Arm or leg pain
- Pain affecting daily living activities, difficulty working , walking and sleep
Minimally Invasive spinal surgery commonly used in
- Laminectomy (decompression surgery): Total or partial removal of the lamina, to relieve pressure on the spinal cord or nerves.
- Laminotomy: Here only a small section of the lamina is removed to relieve pressure on the spinal cord or nerves
- Spinal Fusion- fusion of the painful vertebrae so that they heal into a single solid bone.
- Fractures, Tumors, Infections, Instability and deformity.
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Tests and Diagnosis
- Presenting Symptom by patient
- Physical examination to assess motion, stability, and strength.
- X-rays imaging help to determine the extent of damage
- Magnetic resonance imaging (MRI) scan, or a bone scan may be needed to determine the condition of the bone and soft tissues of your back
- The surgeon will evaluate and discuss the advantages and possible complications of minimally invasive spinal surgery
- Complete medical examination before surgery
- Blood examination to check for normal parameters
- Some medications may need to be stopped before surgery. Non-steroidal anti-inflammatory medications, such as aspirin, ibuprofen, blood thinners.
- This procedure is performed under anaesthesia. The most common types of anesthesia used for MISS are general or regional
- MISS is performed with special tools called tubular retractors.
- During the procedure, a small incision is made and the tubular retractor is inserted through the skin and soft tissues down to the spinal column. This creates a tunnel to the small area where the problem exists in the spine.
- The tubular retractor holds the muscles open and is kept in place throughout the procedure.
- The surgeon accesses the spine using small instruments that fit through the centre of the tubular retractor.
- Any bone or disk material that is removed exits through the retractor, and any devices necessary — such as screws or rods — are inserted through the retractor. Some surgeries require more than one retractor.
- In order to see where to place the incision and insert the retractor, the surgeon is guided by fluoroscopy or endoscopy
- The tubular retractor is removed at the end of procedure and the muscles return to their original position limiting the muscle damage .
- The incision wound is stitched, stapled, or glued
- Antibiotics administered to prevent infection.
- Painkillers prescribed for pain after surgery .
- Patient is usually discharged the same day or within 1-2 days of surgery depending upon the general condition and the procedure .
- It is important to keep follow up appointments with the consultant for check up after surgery .
- Any symptoms of infection must be reported immediately .
- Physical therapy and rehabilitation are important part of recovery process .
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As with any operation, there is a risk of complications. They include:
- Infection- Antibiotics are to lessen the risk of infections.
- Pain at graft site
- Recurring symptoms- Some patients may experience a recurrence of their original symptoms.
- Nerve damage- it is possible that the nerves or blood vessels may be injured, though rare
- Blood clots
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Factors Affecting Cost Of Minimally Invasive spinal surgery
The cost to the patient depends on a variety of factors like:
- The hospital, the patient chooses.
- Type of Room
- Fee for the team of doctors and OT charges
- Standard test and diagnostic procedures
- cost of the procedure
- Cost of the follow –up care required after the procedure