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MINIMALLY INVASIVE SPINE SURGERY

Minimally Invasive Spinal Surgery

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Overview

Minimally Invasive Spine Surgery also known as Minimally Access Spine Surgery or Endoscopic/Keyhole Spine Surgery and abbreviated as MISS is stared as a ground breaking technique as it successfully treats the wide spectrum of spinal intervertebral disc problems with smaller incisions, lesser muscle damage, no damage to the normal structure in spine and minimal recovery time. This technique also helps the expert surgeons to see only the location where the problem exists in the spine. Akin to the conventional spine surgery, the main objectives of MISS procedure are:

  • Stabilizing the Spinal vertebrae
  • Decompressing the pinched spinal nerve
  • Decreasing the pressure on spinal nerves as a result of disc herniation, spinal stenosis, spinal tumors or bony spurs
  • To eliminate painful symptoms, cause by disc herniation, spinal stenosis, spinal tumors or bony spurs


Advantages of MISS

The Minimally Access Spine Surgery is very novel and safer substitute for the conventional spine surgery. Apart for this, the other advantages of MISS technique over conventional spine surgery are as follows;

  • Reduced interventional trauma to the surrounding muscles and adjacent healthy tissues
  • Minimal scarring
  • Less Painful
  • Smaller incisions
  • No risk of infection
  • Faster recovery
  • Reduced rehabilitation time


Causes

The most common spine issues causing back or neck pain that can be treated by minimally invasive spine surgery are enlisted below;.

  • Intervertebral Disc Degeneration : This is the most common cause of lower back pain. In this, the intervertebral disc shrinks in size and wears off with the increasing age. As a result of this, the disc loses its integrity and cushioning ability thereby producing pain and discomfort in the upper or lower back.
  • Spondylolisthesis: In this condition, the vertebrae and ligaments are not able to maintain their position due to aging resulting in slipping of the lower vertebra out of the place. In such instances, the spinal nerves are compressed by this misaligned bone causing back pain.
  • Herniated Intervertebral Disc: This occurs when the weakened disc puts pressure on the centre of the intervertebral disc. Such discs are compressed and bulge outward resulting in disc herniation or sometimes rupture leading to back pain
  • Spinal Stenosis: In this condition, the spinal canal gets narrow down leaving less space for the spinal cord and spinal nerves thereby compressing them and leading to pain and numbness in upper or lower limb.
  • Radiculopathies: Sciatica is the most common radiculopathy condition of the lumber spine in which the spinal stenosis or herniated disc in the lumbar area results in compression, injury and inflammation of the spinal nerve root of the sciatica nerve which causes numbness, tingling sensation and disabling pain that radiates from low back to the buttock and lower leg.
  • Skeletal abnormalities: These includes scoliosis, lateral curvature of the spine or other congenital abnormalities of the lumbar spine that are present from birth resulting in back pain and discomfort.
  • Other Conditions: Apart from the above-mentioned common conditions, there are other medical conditions that can cause low back pain. Enlisted below are some of them;
    • Tumours of Spine
    • Traumatic Injury of the spine
    • Spinal Infections like osteomyelitis
    • Inflammatory diseases of spine comprising of osteoarthritis, spondylosis etc.


Treatment Options

For the above-mentioned spinal conditions, there are two treatment options;

  • Non-Surgical Options:
    • Medical Management
    • Physiotherapy

  • Surgical Options:

    Spine Surgery is often recommended as a last treatment option. It is advisable for the patients where the clinical symptoms are chronic which has not stabilized for more than 2-3 months even after undergoing non-surgical treatment (conservative treatment) including medications, injections or physiotherapy.

    The ultimate aim of the spine surgery is to excise the prolapsed disc part thereby decompressing the spinal cord by releasing the pressure caused by pinched spinal nerves. This is usually performed using one of the following techniques;

    • Spinal Discectomy: In this the herniated disc material that is pressing the spinal cord or spinal nerve root is removed.
    • Percutaneous Discectomy: This technique is used either for the bulging discs or the intervertebral discs that have not herniated into the spinal canal.
    • Minimally Invasive Spinal Decompression: Decompression surgery, as its name suggests is performed to decompress the compressed spinal nerves. It helps to relieve the pressure over spinal nerves by excising the diseased disc, vertebral bone or ligamentum flavum which is pinching over the nerves. This procedure is often advised in cases of spinal canal stenosis which is caused by bony growths, disc herniation, thickened joints or loosened ligaments.
    • It is performed by removing a small part of the vertebral bone that is pinching over the nerve root or by removing a disc material from the nerve root it is compressing so as to provide spinal nerve root more space and provide a better healing environment. There are various procedures which are used for Spine Decompression. They are-

      • Laminotomy or Laminectomy
      • Foraminotomy or Foraminectomy
      • Corpectomy
      • Port Hole Decompression

    • Minimally Invasive Spinal Fusion Surgery: This procedure is performed to reduce pain and nerve irritation by creating a solid bone between the adjacent vertebrae thereby eliminating any movement between the diseased bones. In this surgery the diseased disc is excised and then replaced with the spacer device, pedicle screws and rods that are attached to the back of the involved vertebrae and an interbody fusion spacer is inserted into the disc space from one side of the spine.
    • This fusion surgery is usually done using two approaches depending in the individual patient’s condition. One is the Anterior and another is Posterior approach. The anterior approach involves placing the bone directly into the section between the vertebrae where the shock-absorption disc had been situated.

      Posterior approach however is the most common one in which the surgery is done from the back. Moreover, there are 3 main techniques in this approach, they are;

      • Transforaminal Lumbar Interbody Fusion surgery (TLIF)
      • Posterior Lumbar Interbody Fusion surgery (PLIF)
      • Postero-lateral Gutter Fusion surgery


Are you a Candidate?

You are a right candidate for MISS (Minimally Invasive Spine Surgery) if;

  • You are experiencing chronic back or neck pain
  • You have numbness or weakness in upper or lower limbs
  • You have excruciating pain that is radiating from neck to hands or from back to the buttock or back of the thigh and legs
  • Your pain is interfering with your daily activities
  • You have had tried physiotherapy, medications or other conventional treatment but that has not helped


Procedure

MISS is done under general anesthesia through smaller incisions as compared to the traditional method. The advanced endoscopic instruments are used to perform the surgery in order to get the clear view of the internal organs of the body.

Few smaller incisions are made usually of size less that 0.5 inch. The designed surgical in instruments and excellent video transmitting machines are inserted inside the body through these incisions. Following this, spinal connections are moved to make space for the expert surgeon to place rods, screws, bone grafts as required.

Both the Minimally Invasive Spine Decompression and Fusion surgery are done with the specialized surgical instruments known as tubular retractors. These kind of small incisions on the surgical site easily allows the access of tubular retractor into the skin and soft tissues creating a tunnel to the spine which keeps the muscles and tissues in open position throughout the surgery. Various other surgical instruments can be used through this retractor so that the spinal fusion procedure can be completed which includes placement of rods and screws. Once the entire procedure is completed, the retractors are removed and sutures are placed to close the incisions.



Cost of Minimally Invasive Spine Surgery

India is one of the most affordable places for Minimally Invasive Spine Surgery across the globe. The cost of Minimally Invasive Spine Surgery in India is less than a one sixth of what it costs in Western countries to get the same treatment done.

Here's a look at the approximate costs of Minimally Invasive Spine Surgery in India:

SNo Name of Procedure Cost in India (USD)
1 Evaluation and Investigation 300 - 500
2 Microdiscectomy 3500 - 4200
3 Minimally Invasive Fusion Surgery 5000 - 6800
4 Minimally Invasive Surgery (PLIF/TLIF) 5500 - 7000
5 Artificial Lumbar Disc Replacement Surgery 6000 - 8500


Expected Results

After the MISS surgery, you can expect a remarkable and long-lasting improvements in your back and leg pain. The success rates of the Minimally Invasive spine surgery are excellent. Good nutrition and slowly increasing activity as recommended by the expert surgeon in the recovery period can help achieve success.



Recovery Timeline

Soon after the surgery, you may experience very minimal pain and discomfort which can be very well controlled with the help of analgesics. You would be asked to walk on the same day or most likely the very next day of the surgery in order to prevent ant blood clot formation. Moreover, you would be advised to do regular breathing exercises post-surgery for better circulation of blood and to decrease the risk of any lung problem.

Hospitalization of around 5-6 days is required. You can resume your work usually in 2-3 weeks after the surgery, however, the heavy work is prohibited for few more weeks depending upon your recovery.



Why MedicoExperts?

We at MedicoExperts believe in assisting you to get well-versed with complete information about Minimally Invasive Spine Surgery in India. Being thorough with all the benefits from the appropriate treatment option for spine surgery, will help you make an informed choice.

We also provide you a platform for online video consultation so as to connect you with our chosen top neuro-spine surgeons in India at the best spine surgery hospital in India for all your concerns and queries regarding cancer treatment. We assure you hassle free arrangements for your medical travel, evaluations, treatment, recover and stay in India. With the expertise of MedicoExperts, you can be rest assured about your complete safety, comfort and wonderful experience of medical tourism in India.

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