Minimally Invasive Spine Surgery
Introduction
Traditional spine surgery usually requires long incisions. Muscles are cut and moved away from the spine to expose the surgical area. This causes increased pain, long recovery time and impaired spinal function.
With minimally invasive (keyhole) techniques, surgery on the spine can be performed with a wound of only 2-3cm and many of these can be performed as day surgery. Prolapsed intervertebral disc, spinal stenosis and spondylolisthesis are some of the conditions that can be performed with minimally invasive surgery.
Technique
In minimally invasive surgery a tubular retractor is used to dilate the muscles and create a tunnel to expose the spine (Fig 1a,b). Using the tubular retractor, procedures to relieve pressure on the spinal cord and to remove the slipped disc can be performed.
In patients who require spinal fusion to stabilize the spine, the metal screws and rods can be inserted through small wounds (Fig. 2).
Advantages
1. Smaller scars
2. Less tissue trauma
3. Less blood loss
4. Less postoperative pain
5. Shorter hospital stay
6. Faster rehabilitation
7. Quicker return to work and normal activities
Clinical example
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patient with back pain and both leg pain which is worse with walking. Patient underwent minimally invasive surgery to relieve the pressure on the spinal nerves. He had rapid recovery with a small wound.
References
- Benedict Peng. Clinical and Radiological Outcomes of Minimally Invasive versus Open Transforaminal Lumbar Interbody Fusion”Spine 2009 Jun 1;34(13):1385-9.
Contributing Specialist:
Island Orthopaedic Consultants
Gleneagles Med Ctr,#02-16,
Tel:(65) 6474 5488, 6479 8998
Mt Elizabeth Med Ctr, #06-03,
Tel:(65) 6737 5683
Website: www.iog.com.sg
