Spine Surgery is an advanced treatment option for neck or back pains causing disability due to identifiable lesions in a patient’s spinal column. Almost 80 percent of people across the globe witness back pain sometime or the other during their lifetime. Although back surgery is a difficult choice, there may not be an alternative option especially in cases where conditions have not adequately improved with nonsurgical treatments.
Minimally Invasive Spine Surgery (MISS) is also known as Less Invasive Spine Surgery. Specialized instruments are used in this procedure through small incisions to access operating sites in the spine. MISS was developed to treat spinal problems with little injury to muscles & surrounding tissue structures within the spine. It also allows surgeons to focus view at problematic areas of spine. Other MISS advantages include less bleeding with smaller incisions translating into faster recovery & shorter stays in hospital. However, some back & neck problems cannot yet be effectively treated with minimally invasive procedures.
Spinal discs may get damaged when its outer ring becomes torn or extremely weak. This condition may simply happen as one ages. Some common causes of spinal disc problems are listed below.
- Strain on Back – Spinal discs may get hurt when patients twist or turn to lift heavy objects. Lifting a very huge & heavy object can create great strain on the lower back, resulting in several disc problems.
- Physically Demanding Job – When patients perform a physically demanding job that needs lifting heavy objects, they may be at increased risk for slipped disc problems.
- Overweight – Overweight patients are also at higher risk for getting spinal disc problems because many times discs are not able to support the additional weight.
- Weak Muscles – Sedentary lifestyle & weak muscles may also contribute to the development of spinal problems. These conditions are more common in males than females.
Patients may experience a serious problem in any part of the spine, from neck to lower back. Spinal column is a sophisticated network of blood vessels & nerves. Damaged spinal disc can place excessive pressure on the muscles & nerves around it. Symptoms of ruptured spinal discs include the following.
- Weak Muscles – Patients may have unexplained muscle weakness.
- Numbness – Patients may experience severe pain & numbness, usually on one side of the body.
- Painful Arms & Legs – Harsh pain that extends to patient’s legs or arms.
- Restricted Movement – Pain that worsens with certain movements especially at night.
- Posture – Pain that aggravates after sitting or standing & also while walking short distances.
- Discomfort – Aching, tingling or burning sensations in the affected back areas.
Back pain can vary from patient to patient. Patients should consult a doctor if back pain results in tingling or numbness that affects their capability to control muscles.
In some cases of degenerative discs, kyphosis, scoliosis, spinal column tumors, fractures, infection & herniated discs, minimally invasive surgeries may speed up patient’s recovery, reduce post-operative pain & improve the outcome as well. Various types of minimally invasive spine surgeries provide the following major benefits to patients.
- Repair of herniated discs
- Deformity corrections, such as for scoliosis
- Decompression of spinal tumors
- Stabilization & repair of vertebral compression fractures
- Minimally Invasive Spine Lumbar Discectomy – Herniated discs in the lower back region which pinch a nerve may cause severe weakness, leg pain or numbness. Discectomy is a surgical method to eliminate broken portions of herniated discs located in the spine. In case they are not removed, it can cause numbness, pain or weakness in nearby nerves of spine. All these symptoms initially affect patient’s back & neck & slowly radiate towards legs & arms. On radiating symptoms, discectomy is a better option when it comes to spine surgery. Patients can opt for different non-surgical treatments of neck & back pain like physical therapy or medications for pain. If nonsurgical treatments are not able to relieve symptoms, then spine surgeon might eventually suggest discectomy surgery. This surgery is advanced & is minimally invasive, utilizes small cuts & uses a video camera to see issues & treat them effectively.
- Percutaneous Laser Disc Decompression (PLDD) – Percutaneous Laser Disc Decompression or PLDD is another ‘minimally invasive’ procedure for contained lumbar disc herniation. As this treatment is performed percutaneously, morbidity is lower & convalescence period after operation is shorter than conventional surgery. PLDD appears to be an interesting alternative procedure when compared to conventional counterpart as return to work is possible within a few days after treatment.
- Minimally Invasive Spine Lumbar Fusion – Common MISS Fusion procedure is transforaminal interbody fusion (TLIF). TLIF is a surgical procedure which is utilized to stabilize spinal vertebra & the disc which acts like a shock-absorber. TLIF is designed to create solid bone between adjoining vertebrae by eliminating any movement between bones so as to reduce pain & nerve irritation. TLIF is commonly recommended for disc herniations, spondylolisthesis & degenerative disc diseases. Normally approached from posterior part of spine, TLIF allows surgeons to insert bone graft & spacer into disc space without having to forcefully retract nerve roots so as to reduce injury & scarring.
- Micro Endoscopic Discectomy – This is a minimally invasive procedure utilized to remove herniated disc material which is on the nerve roots or spinal cord. Performed through a tubular device, this procedure uses a specialized microscope so as to view discs & nerves. Usually, an outpatient procedure which allows patients to leave the hospital the same day, Micro Endoscopic Discectomy in no way changes the mechanical structure of lower spine. It may take weeks or months for nerve roots to completely heal after surgery, but most patients feel relief from pain immediately after an operation.
At first, doctors will perform a physical examination. They will try to understand the source of patient’s discomfort & back pain. Surgeons will carefully observe muscle strength & nerve function of the patients & whether they feel discomfort when touching or moving the affected portion. Patients will be asked about their medical history & symptoms & which activities cause pain to worsen. Diagnostic imaging tests may be ordered by spine surgeons to confirm the disc problem & to gain more information, such as position of impinged nerve roots & herniated disc. Imaging tests may include the following.
- Computerized Tomography Scans – During CT scan, an x-ray beam is shot through patient’s body, with a dedicated computer reformatting these pictures into cross section images of spine.
- MRI Scan – Magnetic Resonance imaging or MRI scans help doctors make a sensitive & precise assessment of spinal nerves & anatomy, including disc height, disc alignment, hydration & configuration.
- Discogram – When surgery for spinal disc pain is considered, some spine surgeons may suggest a discogram with an aim of confirming as to which disc is painful. In this procedure, radiographic dye is inserted into the spinal disc with an assumption that the patient is suffering from degenerative disc disease if it is able to recreate normal painful condition.
- Exercise & Healthy Diet – It is extremely essential for patients to be in the best physical & mental health condition before undergoing minimally invasive spine surgery. Patients should eat a healthy diet & perform exercises to stay in good form. Spine surgeons may suggest a program of strengthening, stretching & general aerobic conditioning. Spine surgery patients in better health conditions generally do well & afterwards when they undergo the MISS surgery.
- Medications – It becomes difficult to achieve pain control after MISS surgery if the patient already has developed a tolerance to narcotic pain medicines. Patients should discuss this with the spine surgeon & avoid consuming certain medications.
Patients may have nervousness before undergoing minimally invasive spine surgery. They can take the help of the following list of questions to understand specifics of MISS procedure during consultation with the spine surgeon.
- When should I consider minimally invasive spine surgery?
- Am I a good candidate for MISS?
- Why do I require to get a CT scan, MRI & an X-ray before I undergo this procedure?
- How long will I have to stay at the hospital?
- When can I return back to work after my spine surgery?
- How long will it take for complete recovery?
- How long will discomfort & pain last post-surgery?
- Do I require any pain medicines after my surgery?
- Will I require to wear a brace after surgery?
- Do I have to perform physical therapy after minimally invasive spine surgery?
- What are the advantages & disadvantages of minimally invasive spine surgery compared to the conventional open surgery?
- Which kind of surgery has higher success ratios?
- Is there anything else which I need to know before MISS surgery?
Apart from these questions, patients are free to ask any number of questions that come to their mind. Spine surgeons will provide answers & clear their doubts patiently.
Minimally invasive spine surgery fusions & decompression procedures like laminectomy & discectomy are done with special instruments termed as tubular retractors. During the surgical procedure, a tiny incision is made & tubular retractor is inserted through soft tissues & skin down to the spinal column of patients. Surgeons create a tunnel to the narrow area where the exact problem exists in spine. Tubular retractor grips the spine muscles open & is kept in proper position throughout the procedure. Surgeons reach the spine using tiny instruments that precisely fit through the center of retractor. Any disc material or bone that is eliminated exits through the retractor & some devices required for fusion, such as rods or screws – are planted through the tubular retractor. Some surgical techniques need more than a single retractor. Spine surgeons are guided by fluoroscopy to see where to place the incision & insert the retractor. This technique displays real-time x-ray pictures of the spine on a monitoring screen throughout the surgical intervention. At completion of this procedure, the retractor is taken off & muscles get back to the original place. Minimally invasive surgery for spine limits muscle impairment which is more commonly noticed in open surgeries.
Minimally invasive spine surgery requires a shorter stay at the hospital. Exact time span required in the hospital will alter with each patients’ procedure, but usually MISS patients go back home within three days of time. As minimally invasive procedures do not disturb soft tissues & muscles, it has been observed that post-operative pain is also much lesser than pain after conservative open procedures. To help patients restore muscle strength & speed up recovery, the spine surgeon may suggest physical therapy. Depending upon patient’s general physical condition, the spine surgeon will explain certain exercises to help them become strong enough to perform daily activities & return to normal work. When patients undergo spinal fusion surgery, they may take a few months for the bone to heal & become solid, although their relaxation level will improve much faster. Patients will be advised & given significant instructions as to how to sit, move properly, reposition, walk & stand. Surgeons will examine patients after MISS surgery to make sure that their recovery is progressing as expected.
As with any surgical procedure, there are some risks associated with minimally invasive spine surgery as well. Complications of minimally invasive spine surgery are same as complications associated with open spinal fusion surgeries, but with MISS it is observed that infection rate is very less. Patients should discuss everything with spine surgeons before undergoing surgery.
- Bleeding – Less amount of bleeding is expected, but this is not significant.
- Infection – Antibiotics are consistently given to patients prior, during, & sometimes after MISS surgery to minimize risk of infections.
- Recurring Symptoms – Few patients may experience recurrence of original symptoms.
- Pain – Very small percentage of patients may experience pain at the bone graft site.
- Pseudarthrosis – Patients who smoke are more prone to develop condition of pseudarthrosis. In this condition, there is insufficient bone formation & may therefore lead to a second surgery in order to achieve solid fusion.
- Nerve Damage – It is possible that blood vessels or nerves may get damaged during MISS procedure.
- Blood Clots – This complication is very rare. Blood clots may be formed in patient’s legs.
Minimally invasive spine surgery holds convincing promise, in terms of less pain & faster healing. Maintaining a healthy lifestyle is very important post-surgery. Patients experience a much stable state of spine & are able to perform daily activities smoothly. Patients can fully recover within 4 – 6 weeks of time after MISS procedure. Some major advantages of minimally invasive spine surgery are enumerated below.
- Tiny incisions, generally just a few smaller scars instead of a single large scar
- Lesser damage to nearby muscles
- Lesser tissue dissection
- Less blood loss & lesser pain
- Quicker recovery & shorter hospital stay
- Quicker return to routine activities
Minimally invasive spine surgery could be the best avenue for patients to live a healthy & pain-free life.
Medical Tourism for Minimally Invasive Spine Surgery
India has become a prominent medical tourism destination for overseas patients seeking best minimally invasive spine surgery. India offers both- best spine treatments as well as best spine surgeons for international patients suffering from any kind of spine disorder. Minimally invasive spine surgery is available at an economical cost at majority of internationally accredited multi specialty hospitals having state-of-art facilities under the supervision of well-experienced & certified spine surgeons. Success ratio of these hospital facilities in performing various spine surgeries such as discectomy, spinal fusion, laser disc decompression and so on is extremely high. With more & more people around the world seeking high-quality & affordable healthcare solutions beyond borders, this is an excellent opportunity for them to avail medical procedures for back pain problems.
Minimally Invasive Spine Surgery with Travcure Medical Tourism
Travcure is the most reliable & globally renowned medical tourism company. It is one-stop destination for international patients providing affordable, smooth & successful medical procedures including minimally invasive spine surgery. Healthcare experts at Travcure ensure to provide most suitable & best treatments to patients from top-notch spine surgeons in countries like Turkey, Germany, United Arab Emirates, South Korea, & India. Travcure is associated with world-class internationally accredited hospitals providing a wide spectrum of medical procedures & which have unmatched level of precision in terms of outstanding healthcare amenities. Travcure’s commitment, in fact, begins from the moment patients’ call up to relate their medical problem & continues even after they have returned back to their native land following successful outcomes.
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