Minimally Invasive Spine Surgery
By Dr Benedict Peng Chan Wearn
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.
 Fig. 1a |
 Fig. 1b |
In patients who require spinal fusion to stabilize the spine, the metal screws and rods can be inserted through small wounds (Fig. 2).
Fig. 2
Advantages
- Smaller scars
- Less tissue trauma
- Less blood loss
- Less postoperative pain
- Shorter hospital stay
- Faster rehabilitation
- Quicker return to work and normal activities
Clinical Example
70 year old 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.
 Small 'Keyhole' Wound (2cm) |
 Traditional Wound (8cm) |
References:
- Benedict Peng. Clinical and Radiological Outcomes of Minimally Invasive versus Open Transforaminal Lumbar Interbody Fusion” Spine 2009 Jun 1;34(13):1385-9.
If your spinal problem is causing you discomfort, call us at 6737 5683 to see our Orthopaedic Specialists at Island Spine & Scoliosis. We are committed to helping you manage your pain and keep you as active as possible.
