Minimally invasive spine surgeries: Changing trend

Dr Naveen M A, HOD & Senior Consultant Neurosurgeon, BGS Gleneagles Global Hospital talks about minimally invasive spine surgeries and highlights that it is a safe and effective alternative to conventional technique in the management of spine disease with nil complications and high patient satisfaction

The history of spine surgery dates back to 3000 years. Until the 19th century, open surgery for spine diseases remained the gold standard technique. The concept of Minimally Invasive Spine Surgery (MISS) for all kinds of spine ailments is popular in recent years.

The principle of MISS is to achieve the surgical goals for a better outcome with an efficient route to obtain a specific trajectory to the target with minimal bone work and disruption of the musculo-tendinous attachments. Unlike open spine surgical procedures where the surgeon has the luxury of wide exposure to identify the anatomical landmark as well as multiple trajectories for tissue manipulation, an MIS approach by definition is more restrictive. The compromise between finding a surgical corridor that provides a large enough window to perform decompression while being minimally disruptive has been a perpetual challenge in MISS.

Spine surgery is traditionally a ‘open surgery’ with long incisions and painful post-operative course with longer hospital stay. In recent years with technological advances most of the spine conditions including degenerative disc disease, spondylolisthesis, spinal cord tumors, infections and traumatic spine injuries are being treated with minimally invasive surgical techniques.

The MIS techniques like percutaneous vertebroplasty, percutaneous balloon kyphoplasty and percutaneous epidural neuroplasty are done for alleviation of pain.

The MISS has seen a definite upward trend in India over the past few years. There have been constant innovations to improve MIS since its emergence which include technological innovations in instruments such as tubular retractor systems, transforaminal endoscopes, Image guidance system like neuro navigation, O-arm and robotic systems.

The goal of the MISS is to achieve the best outcome with minimal damage to the tissues. Minimally invasive procedures for spine pathology have been introduced for the better access and visualisation. The MISS is a safe and effective alternative to conventional technique in the management of spine disease with nil complications and high patient satisfaction.

The advantages of MIS is smaller wound size, less tissue damage, less blood loss, nil post-operative pain, reduce chance of infection, reduced hospital stay and early return to work.

A limitation of MIS spine surgery is steep learning curve and access to state of the art equipment.

At BGS Gleneagles global hospital we have performed almost all spine surgeries like Laminotomy, Laminectomy, foraminotomy, discectomy, spinal fusion & stabilisation with implantation, spine infections, spinal cord tumor excision, artificial disc replacement, percutaneous vertebroplasty, balloon kyphoplasty and percutaneous epidural neuroplasty with MIS techniques as a day care procedure.

Minimally invasive surgery is the game changer for all spine ailments in India.



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