Minimally Invasive Spine Surgery

Hospital for Special Surgery has led the way in developing new techniques for minimally invasive surgery (MIS), which involves the use of customized instruments, imaging technology and incisions. These incisions are often smaller than in other forms of surgery. However, the size of the first incision on the skin's surface is not the most important part of the process. More important are the techniques and instruments that allow the surgeon to "tunnel" beneath the muscles and ligaments that surround the spine, while still safely and effectively treating a person's spine condition.

What is minimally invasive spine surgery?

Minimally invasive spine surgery refers to muscle-sparing approaches to the spine that use small incisions as access portals. They are often performed using live X-ray or CT scan imaging for guidance, as well as robotic surgery (also called robotic-assisted surgery). This speeds up recovery periods while achieving the best possible outcomes.

In minimally invasive spine surgery, the surgeon will approach the spine from one of three positions, depending on the patient's age, symptoms, spine alignment, and the anatomy of the nerves and blood vessels. These positions are:

• anterior – from the front
• lateral – from the outer side (flank)
• posterior – from the back

In most cases, access to the spine is established by using a series of dilators that split the muscle to create a working portal. The size of this portal will vary depending on the surgeon and the specific spine surgery being performed. Using these techniques, however, spine surgery access portals can now be as small as 1.2 centimeters (about a half an inch).

When the spine needs to have screws and rods inserted to hold it in position (called instrumentation), this can also be performed through small incisions with the assistance of intra-operative X-rays, CT scans or robotic guidance.

See also Surgery - Back/Neck/Spine.