Los Angeles Minimally Invasive Spine Institute Blog

Your doctor can recommend surgery for different spinal conditions like stenosis, herniated disc, and degenerative disc disease. Surgery is the last option when conservative options like medication and physical therapy are ineffective.

Spine surgery helps to relieve pain and discomfort associated with these conditions. However, many patients are afraid of the complications associated with spine surgery. Minimally invasive spine surgery (MISS) is a common surgical technique for spine surgery.

The technique aims to treat spine conditions with smaller incisions and less muscle and tissue disruption than traditional open surgery. MISS leads to less pain after the procedure, shorter recovery times, and minor scars. If you or a loved one are struggling with spinal issues, you can explore minimally invasive spine surgery. When you consult an experienced spine surgeon, they will determine the suitability of MISS in your case.

Common types of minimally invasive spine surgery include:

Spinal Fusion

Spinal fusion is a surgical procedure that permanently joins two or more bones in the spine. The surgeon uses a graft to fuse the bones and ensure no movement between them.

Surgeons recommend spinal fusion when non-surgical treatments like physical therapy and medication are ineffective. Common indications for spinal fusion include:

• Spinal instability. Conditions like spondylolisthesis can cause instability and pain in the spinal cord.
• Spinal deformities. These are conditions like scoliosis, where the spine is abnormally curved.
• Spinal stenosis. This is the narrowing of the spinal canal that causes compression of the spinal cord or nerves.
• Fractures or trauma. Spinal fractures or trauma can cause instability or misalignment.
• Infection or tumors. Spinal infections or tumors can compromise the spine’s structural integrity, necessitating fusion surgery.
• Chronic back pain. You may need a spinal fusion when you have back pain that does not respond to other remedies.

Minimally Invasive Spinal Fusion Procedure

The steps involved in a typical MIS spinal fusion include:

• Preoperative preparation. Surgeons use imaging studies to assess the spine and determine the exact location for the fusion. Before the procedure begins, the surgeon will administer anesthesia.
• Incision. The surgeon makes small incisions, often 1–2 inches above the area where the fusion is done. Surgeons may use a special microscope or fluoroscopy to guide the procedure.
• Accessing the spine. The surgeon uses specialized instruments to move aside muscles and tissues with minimal disruption. Sometimes, they insert tubes or dilators through the incision to expand the tissue layers.
• Disc Removal. The surgeon can remove the disc in degenerative disc disease or herniation cases. Additionally, a small part of bone or tissue is removed to provide space for the fusion.
• Fusion. Surgeons use bone grafts or synthetic materials to stimulate bone growth between the vertebrae. Some cases involve placing a cage or spacer to hold the vertebrae while the bone graft takes hold. The surgeon can use screws, rods, or plates to stabilize the spine during the healing process.
• Closing the Incision. After placing the fusion materials and spine stabilizers, the surgeon closes the incision with staples or sutures.

Patients are monitored in a recovery room immediately after surgery. After a spinal fusion surgery, the surgeon can discharge you within one or two days, depending on the complexity of your procedure. During the discharge, the doctor will give you aftercare instructions to manage pain and speed up your recovery.

Laminectomy

A laminectomy is a procedure where a portion or all the vertebral bone is removed to relieve pressure on the nerve roots or spinal cord. You are a good candidate for laminectomy if you have the following spine conditions:

• Spinal stenosis. This is the narrowing of the spinal canal, which can compress the spinal cord and nerves. The condition causes pain, weakness, and numbness in the extremities.
• Herniated disc. When a disc in the spine bulges or ruptures, it can press on nearby nerves.
• Degenerative Disc Disease. DDD is an age-related wear of the spinal discs that causes nerve irritation.
• Spondylolisthesis. When one vertebra slips over another, it compresses the spinal cord.
• Tumors or Infections. Benign tumors or infections can compress nerve structures.

Spine surgeons perform minimally invasive laminectomy under general anesthesia. Unlike traditional surgery, the surgeon makes a smaller incision in the skin. They use specialized instruments, including a tubular retractor, to access the affected spine area.

The surgeon removes a part of the lamina to relieve pressure on the spinal cord or nerve roots. Sometimes, they remove a part of the herniated disc. Advanced imaging techniques like fluoroscopy or a microscope guide the surgeon through the procedure.

Artificial Disc Replacement (ADR)

Artificial disc replacement is a surgical procedure to replace a damaged or degenerated spinal disc. You can consider the procedure when other treatment options have failed. You are a candidate for artificial disc replacement if you have the following conditions:

• Chronic back or neck pain. You may need ADR if you have persistent, severe pain in the back or neck.
• Degenerative Disc Disease. DDD causes pain, instability, and loss of motion. If the degeneration is significant and other treatments have not worked, ADR is recommended.
• Herniated disc. If the herniation is severe and conservative treatments are ineffective, ADR may be an option.
• Failed spine surgery. If your back pain persists after a surgical procedure like fusion, your surgeon can recommend artificial disc replacement.

The minimally invasive approach to the artificial disc replacement procedure involves :

• Preoperative evaluation. The surgeon orders MRIs, CT scans, and X-rays to assess the disc damage and alignment of the spine. The surgeon will also review your medical history and general health to ensure you are a good candidate for the surgery.
• Anesthesia. The surgeon administers anesthesia to ease pain and discomfort from the procedure.
• Incision. The surgeon makes a small incision at the front of the neck for cervical ADR or the lower back for lumbar ADR.
• Disc removal. The surgeon uses specialized instruments to navigate through the muscles and tissues. They can also remove bone spurs or other debris contributing to nerve compression.
• Artificial disc insertion. The artificial disc is inserted into the space where the old disc was removed. The device is designed to allow for natural movement of the spine. The goal is to restore the normal height and function of the intervertebral disc.
• Closure. The surgeon closes the incision with sutures or staples and applies sterile dressings. After an ADR procedure, patients undergo close monitoring for a few hours before a discharge.

Spinal Decompression

Spinal decompression is a procedure for relieving pressure on the spinal cord or nerve roots. It involves removing or trimming portions of tissues, such as bone or disc material, that compress the nerves.

Surgeons use minimally invasive surgical techniques for the procedure. The method requires smaller incisions and less tissue interference. The MISS approach minimizes damage to surrounding muscles and tissues and promotes faster recovery.

Minimally invasive spinal decompression is suitable for individuals suffering from conditions that cause compression of the spinal nerves. They include:

• Herniated or bulging discs. These are discs in the spine that have moved out of their normal position and pressed on nearby nerves.
• Spondylolisthesis. This condition arises when one vertebra slips over another, causing nerve compression.
• Degenerative Disc Disease. The breakdown of spinal discs can lead to nerve compression and pain.

The minimally invasive spinal decompression procedure involves:

• Creating small incisions. The surgeon accesses the affected area using small incisions and specialized instruments like endoscopes.
• Removing or trimming tissue.Parts of the herniated disc, bone spurs, or thickened ligaments pressing on the spinal nerves are removed.

The goal is to restore the normal space around the nerves, relieving pain and restoring function. After the procedure, the surgeon offers aftercare tips. Following these instructions reduces the risk of complications and speeds up recovery.

Vertebroplasty

Vertebroplasty is a minimally invasive procedure where a spine surgeon injects bone cement into a fractured vertebra to stabilize the spine. It is used for treating vertebral compression fractures (VCFs) caused by osteoporosis or trauma. Doctors recommend vertebroplasty for patients suffering from severe back pain. Vertebroplasty is also used for patients with fractures resulting from cancer.

The procedure is performed when conservative treatments fail to address persistent and disabling back pain. Before recommending the procedure, the surgeon can order imaging studies, such as X-rays or MRI, to confirm the presence of a fracture.

Minimally invasive vertebroplasty is performed under local anesthesia with mild sedation. After the anesthesia has taken effect, the surgeon makes a small incision in the skin over the fractured vertebra. They then insert a long needle to inject cement into the broken vertebra using fluoroscopic guidance. The cement hardens quickly, stabilizing the bone and reducing the fracture’s pain.

A vertebroplasty takes 30 to 60 minutes, depending on the number of vertebrae treated. Most patients can go home the same day after the procedure. Patients report significant pain relief within 24 hours of the procedure. Recovery time for MIS vertebroplasty is faster compared to more invasive surgeries.

Vertebroplasty carries some risks, as do other surgical procedures. They include infection, cement leakage, and potential anesthesia-related complications. You can minimize these risks by consulting an experienced surgeon. Additionally, you must follow all the aftercare instructions.

Microdiscectomy

Microdiscectomy is a minimally invasive procedure used to relieve pressure on spinal nerves caused by a herniated disc. Surgeons recommend microdiscectomy for patients suffering from lumbar disc herniation. Common indications for the procedure include:

• Disc herniation. It occurs when the disc material protrudes into the spinal cord, compressing the nerves.
• Failed conservative management. If you experience the symptoms of a herniated disc, your doctor can recommend medication and physical therapy. If symptoms persist or worsen after non-surgical treatments, you may need a microdiscectomy.
• Cauda equina syndrome. This is a rare condition causing bowel or bladder dysfunction. Urgent decompression of the spinal cord is necessary to address the issue.

A minimally invasive microdiscectomy is performed by making a small incision over the affected area. The surgeon uses specialized instruments and a microscope to enhance spine visualization. After accessing the affected disc, the surgeon removes it to decompress the spinal nerves. The small incision minimizes muscle disruption, leading to quicker recovery times.

A microdiscectomy procedure takes about 1-2 hours. You may experience immediate relief from symptoms like pain and numbness. Most patients can resume normal activities within a few weeks, with a reduced risk of complications.

Foraminotomy

Foraminotomy is a surgical procedure used to treat nerve root compression. It widens the tunnel in your back where nerve roots leave your spinal canal. Degenerative disc disease, herniated discs, or spinal stenosis cause nerve compression.

These conditions lead to the narrowing of the foramen, which is the passage where spinal nerves exit the spinal column. It causes pain, numbness, weakness, or tingling in the arms or legs. Your surgeon can recommend foraminotomy if you have the following:

• Persistent pain that does not respond to physical therapy or medication.
• Neurological deficits like muscle weakness
• Progressive symptoms that affect your quality of life

Minimally invasive foraminotomy involves small incisions and less tissue damage. However, the surgeon will still administer anesthesia to ease discomfort and any pain from the procedure. After the anesthesia, the surgeon makes a small incision near the affected area.

They use imaging techniques like X-rays or CT scans to guide the procedure. The goal of foraminotomy is to remove or reshape bone and disc material that causes compression on the nerve root. The procedure may involve:

• Removing a part of the vertebrae or disc to widen the foramen
• Decompression of surrounding structures by removing bone spurs

Corpectomy

A corpectomy is a surgical procedure to remove part of the vertebrae and ease pressure from the spinal cord and nerves. The vertebrae can cause pressure on the spinal cord if it is damaged by

• Spinal tumors. These are benign or malignant growths affecting the vertebral body.
• Trauma. The vertebrae can collapse due to osteoporosis or high-impact injury.
• Infection. Vertebral osteomyelitis or discitis, which leads to bone destruction.
• Spinal stenosis. This is the narrowing of the spinal canal that causes nerve compression.

A corpectomy aims to ease pressure on the spinal cord or nerves and restore spinal stability. The process for minimally invasive corpectomy takes these steps:

• Access and exposure. The surgeon makes small incisions to access the spine. They use specialized instruments to separate muscles and tissues around the vertebra without causing extensive damage.
• Vertebral removal. The surgeon removes the damaged vertebra, taking care to avoid injury to the spinal cord or nerves.
• Spinal stabilization. After vertebral removal, the surgeon places a bone graft or synthetic spacer to maintain spinal stability.
• Closure of the incision. Your surgeon will close the small incisions made for the procedure and monitor you for complications.

The minimally invasive technique reduces recovery time and minimizes muscle damage during corpectomy.

Tumor Resection

Spinal tumor resection is a surgical procedure used to remove a tumor located on or near the spine. The spine is a critical structure in the body, and different types of tumors can appear. They include:

• Benign tumors. These are non-cancerous tumors.
• Malignant tumors. These are cancerous tumors from breast, lung, or prostate cancer.
• Intradural tumors. These tumors occur within the spinal cord, and they require delicate surgery.
• Extradural tumors. These tumors are outside the spinal cord and affect surrounding bones and tissues.

Spinal tumors can originate from the spine or spread from other body parts. They appear within the spinal cord, on the spine’s bones, or around the spinal structures. Your spine surgeon can recommend tumor resection to:

• Relieve symptoms such as pain, weakness, numbness, or paralysis caused by compression of nerves or the spinal cord.
• Remove tumors that cause spinal instability or deformity.
• Obtain a biopsy of the tumor for diagnosis.
• Treat malignant tumors that can spread or cause further damage.

Your surgeon can use a minimally invasive approach to remove these tumors. The technique minimizes the damage to surrounding tissues. Unlike traditional open surgery, which requires large incisions, minimally invasive techniques use smaller incisions and specialized instruments. The procedure for minimally invasive spinal resection includes the following steps:

• Preoperative assessment. The surgeon will order an MRI or CT scan to assess the tumor’s location and size.
• Anesthesia and positioning. Depending on the tumour's location, the surgeon will administer anesthesia and position you.
• Incision. In minimally invasive spinal resection, the surgeon inserts a small microscope to guide the tools to the spine.
• Tumor resection. The tumor is removed while preserving surrounding structures and minimizing spinal cord injury.
• Closure and recovery. The surgeon closes the site and gives you some post-operative instructions to speed up the healing.

Find a Competent Spine Surgeon Near Me.

Minimally invasive spine surgery represents a significant advancement in treating spinal conditions. It offers patients a safer and more efficient alternative to traditional open surgeries. Some of the surgical procedures that a surgeon can perform using the minimally invasive technique include laminectomy, discectomy, foraminotomy, and spinal fusion.

During these procedures, your surgeon will make a small incision in the affected area. Through the incision, they can insert specialized tools guided by a microscope to remove the damaged discs, replace them, or decompress the spine. MISS provides relief with fewer risks and faster recovery times.

The spine is a delicate part of your body, and the outcome of your minimally invasive surgery can significantly impact your life. Therefore, you must consult with a reliable spine surgeon. At LAMIS, we offer our Los Angeles, CA, clients safe, reliable, and effective services. Contact us at 310-734-6088 today to book your appointment.