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Minimally invasive spine surgery has been found effective for a wide variety of pain-producing spine conditions such as bone spurs, bulging and herniated discs, spinal stenosis, facet joint disease and others. Since nearly 80% of adults will suffer from lower back pain at some point in their lives, this type of surgery can be quite appealing for those whose pain hasn’t been alleviated by more conservative measures.
But it’s crucial to know exactly what is meant by “minimally invasive” surgery, since true minimally invasive spine surgery is even better at producing less pain, muscle and tissue damage; fewer complications; and a speedy recovery, explains Dr. Liu, who is fellowship-trained in minimally invasive spine surgery.
“Not all spinal operations advertised as minimally invasive are truly minimally invasive,” says Dr. Liu. “Some surgeons are using smaller incisions and less-invasive techniques, but that alone doesn’t make the operation ‘true’ minimally invasive spine surgery.”
What’s the difference? Here, Dr. Liu explains the top myths vs. facts about true minimally invasive spine surgery:
Myth #1: If a small incision is used, it’s minimally invasive
Some surgeons say they perform minimally invasive surgery simply because they use smaller incisions to access the spinal area, Dr. Liu notes. But true minimally invasive spine surgery uses cuts of only an inch or less in length, which leads to less bleeding and pain during and after the procedure.
“So-called ‘open surgery’ – which still has its place in treating scoliosis, tumors and other causes of spine instability – doesn’t always require a huge incision, but shorter cuts alone don’t define a surgery as minimally invasive,” he says.
Myth #2: If retractors are used during surgery, it’s minimally invasive
Even “mini-open” spine surgeries using smaller cuts may use retractors – metal tubes placed into incisions to spread skin and muscle apart – or cut through muscle. But true minimally invasive spine surgery doesn’t crank open or cut these tissues, as may be done in more invasive procedures. Instead, a smaller endoscope is used to perform the procedure through the smallest possible opening, allowing the removal of bone, discs or other material to relieve chronic back pain with minimal disruption to surrounding skin and muscle.
Because true minimally invasive spine surgery preserves muscle function, most patients recover more rapidly and don’t have to wear a back brace beyond the initial follow-up appointment, Dr. Liu says.
“Most post-operative pain or other complications result from what’s been done to the muscle, not the skin,” he adds. “The use of small retractors, with no muscle cutting, is what defines true minimally invasive spine surgery.”
Myth #3: Minimally invasive spine surgery is experimental
Misinformation about minimally invasive spine surgery may include the notion that it’s still experimental, with unclear benefits and risks. But that’s simply not true – especially about true minimally invasive spine surgery, which also leaves less scarring in addition to all its other stated benefits.
“True minimally invasive spine surgery is a highly researched procedure that’s overwhelmingly effective,” Dr. Liu says. “With a track record extending more than 20 years, and techniques that are increasingly improving, the advantages of this type of surgery are clear.”
Kaixuan Liu, MD, PhD, is a board-certified physician who is fellowship-trained in minimally invasive spine surgery at Atlantic Spine Center.
Atlantic Spine Center is a nationally recognized leader for endoscopic and orthopaedic spine surgery with offices in NJ and NY www.atlanticspinecenter.com.www.atlanticspinecenter.nyc
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