Traditional vs. Minimally Invasive Spine Surgery

Ever since minimally invasive spine surgeries hopped onto the medical scene, traditional surgery has had certain stigmas associated with it. Many people, patients and surgeons alike, are under the impression that minimally invasive spine surgery is just flat out better. Such a presumption, however, is misleading, and in some circumstances, downright untrue. Weighing one against the other just doesn’t work; it’s like comparing apples and airplanes. Sure, one is great if you’re hungry, but that’s not really going to help you when your goal is to leap across the ocean.

The general rule is this: if you can go minimally invasive, then do it. But that’s just the thing. Sometimes a patient’s case necessitates more advanced surgical manipulation than minimally invasive procedures allow. And, when a doctor performs a minimally invasive spine surgery in such scenarios, it can lead to problems, including failed back surgery syndrome. Think of it this way: if prescription NSAIDs eliminate your negative symptoms, why go further than that? Likewise, if such a treatment doesn’t provide relief, why would you keep relying on it? This is basically the philosophy behind the traditional vs. minimally invasive spine surgery debate. It’s all about what works for you.

The best thing you can do is to find a surgeon who is well-versed in both methods—someone who understands when one method is better than the other and so on. Dr. Daveed Frazier is one such surgeon. Dr. Frazier graduated with distinction from Harvard Medical School, achieving recognition as a board-certified orthopedic spine surgeon. Additionally, he is a reputable lecturer, accomplished researcher, and a consultant for several international spine companies. For all of your back pain needs, there is no one better whom you can trust.

Key Takeaways

• Surgical Approach: Traditional surgery requires a larger incision and more muscle dissection, while minimally invasive spine surgery (MISS) uses smaller incisions and specialized tools to minimize tissue disruption.
• Recovery Time: MISS typically offers shorter recovery times, less post-operative pain, and quicker returns to normal activities compared to traditional methods.
• Condition Suitability: MISS is ideal for conditions like herniated discs and spinal stenosis, whereas traditional surgery may be necessary for complex spinal deformities or extensive procedures.
• Complication Risks: Minimally invasive techniques generally result in lower risks of infection and scarring, while traditional surgery may carry a higher risk due to its more invasive nature.

What Makes Spine Surgery Minimally Invasive?

To be perfectly honest, there is not a strict rubric that minimally invasive procedures must follow in order to earn that coveted distinction. However, the following typically rings true: minimally invasive procedures employ certain techniques that just are not possible with traditional open surgeries. But I’m sure that has you wondering: what sort of techniques do doctors utilize with minimally invasive procedures?

One of the main differences between the two is that minimally invasive spine surgeries use smaller incisions. Whereas a traditional surgery might use a 3- to 4-inch incision, a minimally invasive procedure will use one or more 1-inch incisions to get the job done. This is one of the main reasons why so many doctors prefer minimally invasive procedures. Furthermore, these procedures typically confer the following benefits:

• Less Blood Loss
• Faster Recovery Times
• Shorter Hospitalization Times
• Less Scarring
• Less Tissue Disruption
• Lower Infection Rates
• Fewer Complications
• Minimal Muscle Damage

Unlike with traditional surgery, minimally invasive procedures circumvent the need to cut directly through muscles in order to accomplish the task. Usually, this feat is accomplished by using a special device called a tubular retractor. Essentially, this instrument is a tube that aids in pushing the muscles to the side so that the surgeon does not have to cut through them. In many cases that involve tubular retractors, surgeons will also funnel an endoscope down the tube. This device provides real-time guidance on a nearby monitor while the doctor performs the procedure.

Other Tools Used In Minimally Invasive Surgery

• Portals: A portal is any device that secures a safe passageway through soft tissues while the surgeon performs endoscopic surgery. Basically, a portal device will hold tissues such as muscles out of the way. This allows the surgeon to safely reach the affected area with their other instruments.
• Fluoroscope: A fluoroscope is an X-ray machine that provides the surgeon with real-time images of the body’s internal structures while the surgeon works.
• Laparoscope: This is another more specialized visualization tool that doctors may use during minimally invasive procedures. A laparoscope is a small, fiber-optic instrument that the surgeon inserts through tiny puncture holes near the affected area. The device then produces images on a nearby monitor, thus allowing the surgeon to see relevant structures in real-time.

Conditions Treated By Minimally Invasive Surgery

Both minimally invasive procedures and traditional surgery cover a lot of ground, though the latter is considerably more versatile in certain cases. After all, sometimes the only viable route is the old fashioned way. That being said, here are some common conditions that may be treated with minimally invasive methods:

• Degenerative Disc Disease: A natural fact of life is that as we age, the body slowly breaks down. Sometimes, this occurs with no painful symptoms. However, in other cases, this gradual breakdown may cause debilitating problems. With degenerative disc disease, the discs of the spine may dry out and crack. This typically means less padding in the spine to absorb everyday stresses, which can lead to disc herniation.
• Herniated Disc: Structurally, the discs of the spine consist of a hard outer shell with a soft jelly-like core. Through means of natural degenerative processes, the outer shell may crack, causing the soft core of the disc to leak out. This material may then press on nearby nerves or the spinal cord itself, generating considerable pain.
• Spinal Stenosis: At its core, spinal stenosis describes a situation in which the spaces within the spine have narrowed through wear and tear caused by osteoarthritis. Usually, only the most severe cases of spinal stenosis necessitate surgical manipulation.

Of course, these are just a few common examples. In most cases, these procedures are easily remedied through minimally invasive methods. Only in the most severe instances where multiple levels of the spine are affected will doctors opt for more traditional procedures instead. Naturally, when this is the case, there is truly nothing better as far as effective treatment goes.

Common Minimally Invasive Procedures

As surgical technologies continue to develop, more and more minimally invasive versions of traditional open procedures will appear. Here are some of the most common minimally invasive procedures that surgeons perform today:

• Foraminotomy: The goal of this surgery is to achieve decompression by enlarging the route where a nerve root exits the spinal canal. The surgeon accomplishes this feat by removing the bone or structure that obstructs the route, which is what causes pressure on the nerve root, to begin with. When nerve roots are compressed in such a fashion, it often leads to painful symptoms.
• Discectomy: Surgeons use this procedure to help alleviate painful symptoms in patients suffering from a herniated disc. In many cases, a herniated disc will apply pressure to nearby nerves or the spinal cord itself, causing pain. To remedy this, a surgeon may perform a discectomy to remove the damaged portion of the affected disc and thereby relieve adjacent nerve pressure.
• Laminotomy: This procedure involves removing a small portion of the lamina to create more space near the spine, thereby relieving pressure on adjacent structures caused by conditions such as spinal stenosis. For context, the lamina is a bony portion of the vertebral arch that comes together to form the roof of the spinal canal.

FAQs

1. What is the main difference between traditional and minimally invasive spine surgery?
   Traditional spine surgery involves making a larger incision to access the spine, which may require cutting through or moving muscles and tissues. This approach provides the surgeon with a broader view of the area being treated but typically involves a longer recovery period and more post-operative discomfort.
   Minimally invasive spine surgery (MISS), on the other hand, uses smaller incisions and specialized tools, such as microscopes or cameras, to reduce disruption to surrounding tissues. MISS often results in shorter recovery times, less scarring, and reduced post-operative pain compared to traditional methods.
2.  Is minimally invasive spine surgery suitable for all spine conditions?
   No, minimally invasive spine surgery is not appropriate for every spine condition. It is commonly used for conditions like herniated discs, spinal stenosis, and certain types of spinal deformities. However, complex cases such as severe scoliosis, spinal tumors, or infections may require traditional open surgery for comprehensive access and treatment. A spine specialist can determine the best surgical option based on the patient’s condition, anatomy, and overall health.
3. How does recovery differ between traditional and minimally invasive spine surgery?Recovery from minimally invasive spine surgery is typically faster and less painful due to the smaller incisions and reduced muscle damage. Many patients can return to daily activities within weeks, and the risk of complications, such as infections, is often lower.
   In contrast, traditional spine surgery usually involves a longer recovery period, often spanning several months, as the larger incisions and muscle disruption take more time to heal. Rehabilitation may also be more intensive for traditional surgery patients.

Contact Us

Do you have back pain that is not going away with conservative treatment methods? If so, you may want to contact New York City Spine at (855) 210-0899. Dr. Daveed Frazier and his team of highly trained spine experts are passionate about providing the highest level of care to all patients that walk through their doors. You can rest assured knowing that we will work tirelessly to identify an individualized care plan that suits the specific needs of your unique case.