The spine is made up of vertebrae, disks, joints and ligaments. Back pain may result from injury or degeneration “wearing out” of these structures producing degenerative disk disease (black disk disease), spondylolithesis (the spine slipping apart), facet arthropathy (worn out and thickened facet joints), spinal stenosis (arthritis pinching spinal nerves) and compression fractures.
Traditional surgery involved very large midline skin incisions, dissection and retraction of the muscles, blood loss, and bone removal. This resulted in muscle and soft tissue damage producing pain, disability and prolonged recovery.
The development of percutaneous techniques, specialized spinal toolsand instrumentation and cameras and microscopes made minimally invasive spine surgery possible. Advantages of minimally invasive spine surgery are small skin incisions, muscle dilation rather then retraction, decreased bone removal and blood loss decreasing pain and recovery time after surgery.
Minimally invasive lumbar fusion surgery involves the decompression, fusion and instrumentation of the spine through minimally invasive techniques.
Overview of the Procedure:
1. The level of damaged disk is identified with X-ray
2. K-wire or dilator tube is placed onto the spine
3. The skin and soft tissues are sequentially dilated with series of increasing larger diameter tubes
4. Bone is removed through the tube to decompress the stenosis and identify the disk
5. The disk is removed under endoscopic or microscopic visualization through the small tube
6. Spinal implant and bone is placed into the disk space for fusion of the vertebrae
7. Pedicle screws and rods are placed to hold the spine together to provide stability and promote healing
8. Incisions are closed with dissolvable sutures and don’t need to be removed
Patients are usually observed in the hospital or surgery center until ready for discharge home.