Surgery Overview

What Is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery, also known as “MISS surgery,” is a surgical procedure used to treat a variety of spinal conditions, such as herniated discs, spinal stenosis or degenerative disc diseases.
It is referred to as "minimally invasive" because it involves smaller incisions and less disruption to surrounding tissues, compared to traditional open spine surgery. The benefits of minimally invasive spine surgery over traditional spine surgery can include less postoperative pain and scarring, faster recovery times, and shorter hospital stays, so you can get back on your feet pain-free as soon as possible.

PRACTITIONERS

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Arash Emami, M.D.

Orthopedic Spine Surgeon

Ki S. Hwang, M.D.

Orthopedic Spine Surgeon

Nikhil Sahai, M.D.

Orthopedic Spine Surgeon

Kumar G. Sinha, M.D.

Orthopedic Spine Surgeon
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About Minimally Invasive Spine Surgery

About-Minimally-Invasive-Spine-Surgery

Who Might Need Minimally Invasive Spine Surgery?

Minimally invasive spine surgery is becoming more popular and is also expected to have an annual growth rate of 5.5% in the upcoming years.

Research shows that patients who choose minimally invasive spine surgery instead of an open spine surgery, have 78% more preoperative confidence for the procedure.

If you’re experiencing severe back pain or limited mobility due to spinal stenosis, spinal deformity or a disc condition, minimally invasive spine surgery or minor back surgery may be right for you — especially if non-surgical treatments like physical therapy or medication have not been effective.

Minimally invasive spine surgery can be used to treat:

  • Degenerative disc disease
  • Herniated disc
  • Spinal stenosis
  • Spinal deformities
  • Spinal instability
  • Spinal infections
  • Sciatica
  • Spondylolysis
  • Fractured vertebra
  • Removal of a tumor in the spine

At OrthoEast, our board-certified physicians are committed to providing comprehensive care, from your initial consultation and surgery to your post-op care.

Each of our physicians has a track record of delivering excellent outcomes for patients who require minimally invasive spine surgery to alleviate pain and improve their quality of life.

Our specialists include Dr. Arash Emami, Dr. Ki S. Hwang, Dr. Kumar G. Sinha and Dr. Nikhil Sahai.

Like any surgical procedure, you should opt for minimally invasive spine surgery after careful consultation with your orthopedic specialist.

We offer many solutions for pain relief, pain management and spinal care, including spinal fusion alternatives, disc replacement, and even pediatric spine procedures for our youngest patients.

We understand that the thought of spine surgery can be daunting, which is why our team focuses on providing a personalized approach to your care. Our fellowship-trained, board-certified physicians provide full-spectrum treatment and seek to build meaningful relationships with patients to help you navigate your procedure with greater comfort and confidence.

Conditions That Require Minimally Invasive Spine Surgery

Conditions that require minimally invasive back surgery include:

Degenerative Disc Disease (DDD) is a condition that occurs when the discs between your vertebrae start to wear down. Symptoms of DDD include pain, stiffness and limited mobility, which can be alleviated by minor back surgery like minimally invasive spine surgery.

A herniated disc is a condition in which the soft inner portion of a spinal disc protrudes through the outer layer. This can cause pain, numbness, and weakness in the arms or legs. While herniated discs can happen in any region of the spine, they typically occur more frequently in the lower back and neck areas. Minimally invasive spine surgery can be performed to remove the damaged portion of the disc and relieve the pressure on the nerves.

Lumbar spinal stenosis is a condition in which the spinal canal in the lower back narrows, putting pressure on the nerves. This can cause pain, numbness, and weakness in the legs and is mostly caused by natural aging, arthritis or a herniated disc.

Minimally invasive spinal stenosis surgery can help create more space in the spinal canal and relieve pressure on the nerves.

Spinal deformities including scoliosis, kyphosis and spondylolisthesis can all be treated with a minimally invasive spine surgery. MIS techniques for spinal deformities involve making small incisions and using specialized instruments to correct the alignment of the spine.

Spinal infections can be treated with minimally invasive spine surgeries, although the exact procedure depends on the type and severity of the infection.

The surgery techniques for spinal infections may involve making a small incision and using specialized instruments to remove infected tissue, drain abscesses, and stabilize the spine.

Sciatica is a medical condition in which the sciatic nerve, which extends from the lower back to the legs, becomes irritated or compressed.

Pain, weakness, numbness, and a tingling sensation in the lower back, buttocks, and legs can be experienced as a result of this. Minimally invasive spine surgery can help with sciatica by relieving the pressure on the sciatic nerve.

The slipping of one vertebra over the one below it is known as spondylolisthesis, and it can result in pain. The surgery techniques for spondylolisthesis can involve making small incisions and using specialized equipment to stabilize the affected vertebrae.

Vertebral compression fractures occur when one or more vertebrae in the spine collapse or become compressed, often due to osteoporosis or trauma.

In a vertebroplasty procedure, a specific type of cement is injected into the vertebra that has suffered a fracture. This helps in stabilizing the spine and alleviating the pain.

Spinal tumors can be caused by a variety of factors, including primary tumors originating in the spine, metastatic tumors spreading from other parts of the body, genetic factors, radiation exposure, age, and immune system disorders.

Spinal tumors can cause pain, numbness, and weakness. Minimally invasive spine surgery can remove the tumor and relieve pressure on the nerves.

Types Of Minimally Invasive Spine Surgeries At OrthoEast

At OrthoEast, our skilled physicians perform various procedures related to minimally invasive spine surgery, including: 

ALIF and PLIF are procedures in which damaged discs are removed and replaced with bone grafts or implants.

In an ALIF procedure, we make an incision in the abdomen and remove the affected disc from the front of the spine. Then we insert a bone graft or artificial spacer into the disc space, which helps to maintain the height and alignment of the spine. Metal screws and rods may also be inserted to provide additional support while the bone graft fuses with the surrounding vertebrae.

In a PLIF procedure, we make an incision in the back and remove the affected disc from the back of the spine. Similar to ALIF, we then insert a bone graft or artificial spacer into the disc space, along with metal screws and rods to provide support while the bone graft fuses with the surrounding vertebrae.

In this procedure, the damaged disc is removed and the vertebrae is fused together.

First, we make a small incision in the front of the neck and remove the affected disc, relieving pressure on the spinal cord or nerve roots. Then we insert a bone graft or artificial spacer into the disc space, which helps to maintain the height and alignment of the spine.

A microdiscectomy is a minimally invasive surgical procedure used to treat sciatica, a condition caused by the compression of the sciatic nerve, which can result in pain, numbness and weakness in the lower back and legs.

In the procedure, we make a small incision only 2-3 cm long in the lower back and use specialized instruments to remove the portion of the affected disc that is pressing on the sciatic nerve.

Because the procedure is minimally invasive, it typically requires only a short hospital stay from one to two days, and allows for a faster recovery time than traditional open surgery.

Cervical micro foraminotomy is a minimally invasive surgical procedure used to treat conditions affecting the cervical spine, such as herniated discs, spinal stenosis, and degenerative disc disease.

In the procedure, we make a small incision in the back or side of the neck to remove the portion of the affected vertebrae that is compressing the spinal nerve.

The procedure is called “micro” because the incision is very small, and “foraminotomy” refers to the process of widening the opening in the vertebrae through which the nerve exits the spinal canal.

XLIF is a procedure in which the damaged disc is removed and replaced with an implant through a small incision in the side of the body.

Through this incision, we’re able to access the spinal disc space from the side, rather than from the back or front. This allows us to remove the affected disc and insert a bone graft or artificial spacer to restore the height and alignment of the spine.

XSTOP is a minimally invasive surgical procedure used to treat spinal stenosis, a condition in which the spinal canal narrows and puts pressure on the spinal cord and nerves, leading to pain, weakness, and numbness in the back and legs.

In the procedure, we make a small incision in the lower back and insert a small implant between the spinous processes of the affected vertebrae. The implant is designed to keep the spinal canal open and relieve pressure on the affected nerves.

Surgery to implant interspinous spacers is a minimally invasive spine surgery used to treat spinal stenosis, a condition where the spinal canal narrows and puts pressure on the nerves, causing pain and discomfort.

During the procedure, we make a small incision in the back to insert a small device called an interspinous spacer between the spinous processes, which are the bony protrusions on the back of each vertebra.

The spacer serves to widen the space between them, reducing pressure on the nerves and providing relief from mentioned symptoms.

Vertebroplasty is a minimally invasive spine surgery used to treat vertebral compression fractures, which are commonly caused by osteoporosis — a condition that weakens the bones. 

During the procedure, we use X-ray guidance to inject a special type of bone cement into the damaged vertebrae, which hardens and stabilizes the bone.

Kyphoplasty is a minimally invasive spine surgery used to treat vertebral compression fractures, which can cause the spine to become hunched or “humpbacked” (a condition known as kyphosis).

During this procedure, we insert a balloon-like device into the affected vertebrae, which is then inflated to create a space for the injection of bone cement. The injection of bone cement helps the condition by stabilizing the fractured vertebra and providing immediate support to the spine.

Cervical posterior decompression is a minimally invasive spine surgery used to relieve pressure on the spinal cord or nerves in the neck region (cervical spine). The pressure can be caused by several conditions such as a herniated disc, spinal stenosis or a degenerative disc disease.

During this procedure, we make a small incision in the back of the neck and remove a portion of the lamina —the bony arch that covers the spinal cord — to create more space for the nerves.

Minimally invasive lumbar decompression is a procedure used to relieve pressure on the spinal cord or nerves in the neck or lower back region.

In this procedure, a part of the bone or soft tissue that is pressing against the spinal cord or nerves is removed.

Micro Transforaminal Lumbar Interbody Fusion (TLIF) is a minimally invasive spine surgery technique used to treat lower back pain caused by conditions such as degenerative disc disease, spondylolisthesis or spinal stenosis. The patient satisfactory rate for TLIF in the following 2 years after the surgery is 95%.

During this procedure, we place patients under general anesthesia and make a small incision in the lower back. We remove the damaged or degenerated disc material and replace it with a bone graft or artificial disc, then insert crews and rods to stabilize the spine and promote fusion between the vertebrae.

How Is Minimally Invasive Surgery Performed?

Our board-certified physicians use advanced technology and proven techniques to guide every procedure with accuracy and the utmost care.

Here is a general overview of how MIS spine surgery is typically performed:

  • Anesthesia: Before the surgery, you’re given anesthesia to ensure you’re comfortable and pain-free during the procedure.
  • Incision: We make a small incision in the skin above the affected area of the spine.
  • Access: Using specialized surgical tools, we carefully move muscles and other tissues aside to access the spine.
  • Imaging: We use real-time X-ray or other imaging techniques to guide the placement of surgical instruments and implants.
  • Surgery: We perform the necessary procedure, which may include removing damaged discs or bone, fusing vertebrae together, or placing implants.
  • Closure: Once the procedure is complete, we close the incision using sutures or adhesive strips.

Compared to traditional open surgery, MIS spine surgery offers several advantages, including smaller incisions, less blood loss, a reduced risk of infection, and faster recovery time.

How To Prepare For Minimally Invasive Spine Surgery

To prepare for your surgery, you may need to undergo additional tests, such as X-rays or MRI scans, to provide a more detailed view of your spine.

If you smoke, you’ll need to stop smoking ahead of time, as it can delay your healing. You may also need to stop taking medications before surgery, depending on the type of medication you take — our team will walk you through exactly how to prepare for your surgery, including food and drink restrictions before the procedure and medications to avoid.

How Long Does Minimally Invasive Spine Surgery Take?

The time it takes to perform a minimally invasive spine surgery varies depending on the exact procedure and the patient’s condition.

In general, minimally invasive spine surgery takes less time than traditional open surgery because it involves smaller incisions and causes less disruption to surrounding tissues.

Some minimally invasive procedures, such as a microdiscectomy or XSTOP, can be completed in as little as 30 minutes to an hour.

Other procedures, such as XLIF or ALIF, may take several hours to complete. Our team will provide you with an estimated time frame for your procedure prior to surgery, based on your condition and the planned approach.

What To Expect After Minimally Invasive Spine Surgery

After the surgery, you will be monitored in the recovery room for a short time before being transferred to a room in our spine center or discharged to return to the comfort of your home, depending on the type of procedure and your condition.

You may experience some discomfort and soreness at the incision site as you heal, which can be managed with pain medications.

Physical therapy after minimally invasive spine surgery is also an important part of the recovery process. In general, patients can expect to participate in physical therapy for several weeks to several months following surgery.

Following the procedure, it may be necessary to restrict lifting or bending, and to wear a back brace for a period of time.

Our board-certified physicians will provide you with specific instructions on how to care for yourself after the surgery, including when you’ll be able to return to normal activities.

What’s The Recovery Time From Minimally Invasive Spine Surgery?

You can expect to return to light activities within a few days to a week after surgery, and resume normal activities within 4-6 weeks.

In most cases, you can leave our center on the same day or the day after surgery, depending on the specific procedure and your condition.

You may need to take some time off work to rest and recover, but this is usually only a few days to a week.

Not sure if minimally invasive spine surgery is right for you?