Minimally invasive spinal fusion surgery, also called MIS fusion, offers great results without a big and long surgical procedure and benefits people with chronic back pain to quickly get back to their daily and recreational activities, according to Endoscopic Spine Surgeon Kaixuan Liu, MD, PhD and founder of Atlantic Spine Center. Unlike traditional "open" spinal fusion in which long incisions are used to access spinal structures, minimally invasive spine surgery requires much smaller cuts. This allows the surgeon to realize equal results with much less pain and a much faster and easier recovery.
"We find that many of our patients are unclear or confused about MIS fusion, including how it works and why it's better in some cases than traditional open spinal fusion. Dr. Liu offers the following 5 top things to know about MIS fusion in an attempt to clear up any misunderstandings.
Performed since the 1990s, MIS fusion fixes problems with the vertebrae, the small bones of the spine, by fusing together vertebrae that are causing pain so that they heal into a single, solid bone. The benefit is that this alleviates the vertebral bones from "grinding" together, which can cause bone spurs, arthritis, and other pain-producing problems.
"We find that many of our patients are unclear or confused about MIS fusion, including how it works and why it's better in some cases than traditional open spinal fusion. Dr. Liu offers the following 5 top things to know about MIS fusion in an attempt to clear up any misunderstandings.
Performed since the 1990s, lumbar fusion surgery fixes problems with the vertebrae, the small bones of the spine, by fusing together vertebrae that are causing pain so that they heal into a single, solid bone. The benefit is that this alleviates the vertebral bones from "grinding" together, which can cause bone spurs, arthritis, and other pain-producing problems.
What is Minimally Invasive Spinal Fusion?
Minimally invasive spinal fusion is a surgical procedure that is used to treat spinal conditions such as degenerative disc disease, spinal stenosis, and spondylolisthesis. This type of surgery is less invasive than traditional open spinal fusion surgery, as it uses smaller incisions and specialized instruments to access the affected area of the spine.
During minimally invasive spinal fusion surgery, the surgeon makes one or more small incisions in the patient's back, typically less than an inch in length. Through these incisions, the surgeon uses specialized instruments and a small camera to access the affected area of the spine.
The surgeon then removes damaged or diseased disc material from the spine and fuses the affected vertebrae together using bone grafts and other specialized hardware. The goal of the surgery is to stabilize the spine and alleviate pain and other symptoms.
Minimally invasive spinal fusion surgery has several benefits over traditional open spinal fusion surgery. The smaller incisions used in minimally invasive spinal fusion surgery result in less tissue damage, less blood loss, and a faster recovery time. Because the incisions are smaller, the resulting scars are also smaller and less noticeable. The smaller incisions and reduced tissue damage also reduce the risk of infection following the surgery.
Patients who undergo minimally invasive spinal fusion surgery typically experience a faster recovery time and can return to normal activities sooner than patients who undergo traditional open spinal fusion surgery. Despite these benefits, not all patients are candidates for minimally invasive spinal fusion surgery. The procedure is typically only recommended for patients with specific spinal conditions and those who are in otherwise good health.
Who's an ideal contender for MIS fusion?
MIS Fusion is commonly advised for patients suffering from persistent back pain from a variety of causes such as recurrent lumbar disc herniation, which occurs when the jelly-like center of a disc bulges between the vertebrae and pushes on nerves; lumbar degenerative disease, which causes radiating pain from damaged discs in the spine; spondylolisthesis, in which one vertebra slides forward over another below it and squeezes the nerves; or foraminal stenosis requiring disc height restoration, a situation where there is a narrowing of spine openings resulting in nerve compression.
How is MIS fusion surgery performed?
MIS fusion surgery is performed with specific tools called tubular retractors. These tools are inserted into a small incision and through soft tissues to the specified location on the spine, causing pain. The retractor holds the muscles open while a surgeon can remove any problematic tissue. The surgeon then sets screws or rods in place that will fuse the vertebrae together. The surgeon gains access to the spine through the patient's back or side. This "point of entry" defines the exact procedure and its specific name (common MIS fusion names include XLIF, TLIF and OLLIF).
MIS Fusion Surgery Recovery
Unlike traditional open spine fusion surgery, MIS fusion is an out-patient procedure and doesn't require a stay at the hospital. Since the blood loss in MIS fusion is minimal, most patients are up and walking around the same day as the procedure, adds Dr. Liu. While some traditional open spine fusion surgery involves a recovery of 6 months or longer, most MIS fusion patients return to routine activities in 4 to 6 weeks. MIS Fusion patients can start driving once post-operative pain has been reduced to mild, which usually happens in 7 to 14 days. In most cases, after the initial spinal fusion recovery, physical therapy sessions are recommended to help strengthen the back muscles and improve mobility and flexibility.
Care After Minimally Invasive Spinal Fusion Surgery
After undergoing minimally invasive spinal fusion surgery, it is important to follow your surgeon's post-operative care instructions to ensure a smooth and successful recovery.
You may experience some discomfort and pain after the surgery. Your surgeon will prescribe pain medication to help manage your symptoms. It is important to take the medication as directed and not to exceed the recommended dose.
Your incisions will be covered with dressings, which should be kept clean and dry. You may be instructed to change the dressings and clean the incision site regularly. Follow your surgeon's instructions for incision care to prevent infection.
You will need to limit your physical activity for a period of time after the surgery. Your surgeon will provide specific guidelines for how long you should avoid certain activities, such as lifting heavy objects or bending. However, walking is encouraged after the surgery to help prevent blood clots and promote healing. Start with short walks and gradually increase the distance and duration as tolerated.
Follow-up appointments: You will need to attend follow-up appointments with your surgeon to monitor your progress and ensure that your incisions are healing properly. Your surgeon may also recommend physical therapy or other rehabilitation exercises to help restore strength and flexibility in your back.
It is important to eat a healthy, balanced diet and stay hydrated to promote healing and reduce the risk of complications. Smoking can slow down the healing process and increase the risk of complications. If you smoke, it is important to quit or at least avoid smoking for a period of time after the surgery.
MIS Fusion Benefits
There are many pluses of MIS fusion, including less blood loss during surgery and a reduced need for blood transfusions using the minimally invasive technique. In most cases, patients require less pain medication following MIS fusion, adds Dr. Liu. "However, the biggest benefit of MIS fusion is that it stops the aberrant movement between the spinal vertebrae with a technique that causes much less damage to the adjacent tissues than in an open surgery," he adds. "MIS fusion more gently spreads muscles, as opposed to cutting and moving muscles, allowing quick access to the spine. This procedure is much less traumatic and painful for the patient, and it doesn't require as long for muscles to heal."
MIS Fusion Risks
Minimally invasive spinal fusion is a surgery that involves using small incisions and specialized instruments to treat spinal conditions. Although it carries certain risks, such as infection, nerve damage, blood loss, instrumentation failure, failure to fuse, and anesthesia complications, these risks can be minimized with proper planning and technique. It is essential to discuss the risks and benefits of the surgery with a surgeon before deciding to undergo the procedure.
