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What is Minimally Invasive Spine Surgery?

Minimally Invasive Spine Surgery (MISS) is surgery on the bones and ligaments of your spine that uses smaller incisions than standard open surgery. This surgery requires a longer incision down the neck or back so the muscles and soft tissue around the spine can be moved away. In some cases, tissue would need to be removed.

"Compared to traditional open spine surgery, minimally invasive surgical approaches are faster, safer and require less recovery time," according to Sujal Patel, MD , Managing Partner of Oasis. Dr. Patel is a spine surgeon who specializes in MISS, endoscopic spine surgery, robotic and motion-preserving disc replacement of the cervical and lumbar spine.

"Although there are some surgeries that need to be done the traditional way, such as scoliosis, which is an abnormal curvature of the spine, most back and neck surgeries can be done using MISS," Dr. Patel said. "Instead of cutting through muscle, surgeons performing MISS are going through the muscles which helps with patient recovery and decreases complications.

What are the advantages of MISS over traditional surgery?

Dr. Patel notes that the advantages of MISS over traditional open spine surgery include:

  • Faster recovery times and less rehabilitation
  • Less blood loss compared to traditional open surgery
  • Reduced risk of infection and post-operative pain
  • Reduced risk of muscle damage and scarring as less cutting of the muscle is required
  • Less need for painkillers, especially opioids
  • Less damage to skin due to smaller skin incisions

Minimally Invasive Surgical procedures can be used to treat a variety of spine and extremity disorders. The Oasis Medical Group uses the newest proven techniques in spine, back, and neck procedures to help patients re-discover a life free of pain. The surgeons working at Oasis have performed thousands of surgical procedures and, as a result, have among the highest success rates for musculoskeletal surgeries. If you are experiencing persistent pain and have tried conservative care treatments, it may be time to explore your options.

What Steps Should I Consider Before Having Spinal Surgery?

Dr. Patel notes that any surgery, minimal or traditional, should only be considered once a patient has not responded to conservative measures such as rest, ice and heat, over-the counter anti-inflammatory medications, and epidural injections. "Let's face it, everyone has had back pain at some time in their life. You do not need surgery for ordinary back pain."

Unless it is an emergency, such as bones being broken due to an accident, your doctor will examine you and prescribe a course of physical therapy and/or chiropractic therapy. Alternatively, many patients are helped by pain relievers or cortisone and other injections.

"Most people who have back pain usually do well, but if the conservative treatments do not help or if you have pain radiating down your arms or legs, you may need surgery," Dr. Patel said. "At Oasis we only advise back surgery for conditions that it has been proven to help such as herniated discs; spinal stenosis (narrowing of the spinal canal); certain spinal deformities, as well as fractured vertebrates and infections of the spine."

What happens during minimally invasive spine surgery?

A spine surgeon and a trained medical team do MISS. You will have anesthesia that numbs your body and sedation to relax you during surgery. In consultation with your healthcare team, you might be given general anesthesia which both prevents pain and causes you to sleep through the surgery.

Once you are sedated your surgeon will make a small incision. He or she will then insert a device called a tubular retractor, a stiff, tube-shaped tool, that exposes the part of the spine to be treated and allows the surgeon to put small tools through the retractor such as a tiny camera and a light. The camera allows magnified visualization of the spinal anatomy. The tube helps keep the muscles out of the way and allows the surgeon to do the surgery with minimal or no damage to the muscles. Then the surgeon will do the necessary repairs to the spine, remove the tools and tubular retractor and close the incision.

What are the risks of minimally invasive spine surgery?

Every surgery has risks, but the risks of MISS are less than the risks of traditional spinal surgery. During MISS you are given less anesthesia because it is a shorter surgery compared to traditional spinal surgery. And MISS surgery is more precise, due to being able to visualize the surgical area via camera, meaning less cutting and blood loss.

The risks of MISS include infections, bleeding, pain, nerve damage, blood clots and complications from anesthesia. But the risks are less than those of traditional spinal surgery. Dr. Patel notes that patients' risks vary according to the patient's age, general health, and the type of surgery. "That's why it is important to have surgery at a facility such as OASIS whose surgeons are trained and experienced in MISS to help lower your risks of complications."

What Happens After MISS? Will I be in Pain?

Most MISS surgeries can be done as an outpatient procedure. Most patients go home the same day. However, you will need to stay for a couple of hours after the procedure so your surgical team can make sure there are no complications. Having been sedated, you will need to have a loved one or friend take you home.

As for pain, Dr. Patel says like any surgery, most patients experience pain. "You will probably be advised to limit lifting or bending for a few days after the surgery. And you will probably need physical therapy after the surgery to strengthen your back muscles and core. Depending on what surgery you had and your overall health, you should be able to go back to normal activities in a few weeks."

Is MISS Covered by Insurance?

Yes. MISS is surgery. It is not considered experimental. It is covered the same as traditional surgery.

Which Oasis Centers offer MISS?

All our OASIS centers provides consultation on MISS.