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What is Minimally Invasive/ Endoscopic Spine Surgery?
It is a scarless and bloodless procedure performed under local anaesthesia when the patient is awake. After the anaesthesia is given, a needle is passed through the target area of the spine under imaging guidance. Sub sequentially a trajectory is made over the needle and a 6mm hollow tube is inserted through which a spine endoscope is passed. The disc or disease is removed by Holimium YAG laser, radiofrequency cautery or by endoscopic forceps. The surgery is completed once the spinal cord and nerve roots are made free, and visualised for enough decompression.
Am I a candidate for minimally invasive spine surgery?
Dr Priyank Uniyal says The field of minimally invasive spine surgery is growing continuously. Most of the spine surgeries today can be treated with some aspect of minimally invasive surgery. For young patients, it is miracle surgery as there are no scars and for older patients, there are no risks of general anaesthesia or other related complications. However, there are certain conditions that require standard open treatment such as high degree scoliosis, tumours and infections.
How long will I be in the hospital?
In a typical endoscopic discectomy, the surgeries are performed on the same day, and the patients go home shortly after surgery. In general, minimally invasive spine surgery decreases the hospital stay by 50% as compared to open spine surgery. For various types of lumbar fusion surgery, the patient typically goes home in 2-3 days. Furthermore, the immediate post-operative period is marked by less pain on using minimally invasive techniques.
When can I go back to work after minimally invasive back surgery?
The decision to return to work should be individualised to the patient, as well as the patient’s occupation. For patients with sedentary jobs, such as office work, a minimally invasive discectomy would allow that patient to begin part-time work within 1-2 weeks. For a larger surgery such as a fusion, this may take up to 4weeks. Again, return to work is much faster using minimally invasive surgery as compared to a standard open surgery but this decision is individualised to special needs of each patient.
Do I have to wear a brace?
Most patients are provided with a brace for their comfort. The minimally invasive techniques use specialised implants, which act as an internal brace so the patient can avoid the use of the brace. Most patients find that the brace improves their pain for about 1-2 weeks, and so they prefer wearing it occasionally.
Why aren’t more hospitals and surgeons performing MIS surgeries?
Minimally invasive surgery is highly technical. This requires significant training of the Neuro surgeon / Neurologist as well as the OR staff. Furthermore, the equipment needed to perform these procedures safely and effectively can be very expensive.