Minimally Invasive Spine Surgery

What Is Minimally Invasive Spine Surgery?

Surgery on the spine is a challenge due to its sensitive location and preferably carried out minimally invasive for many clinical pictures. Surgical treatment aims to relieve pressure on neural structures to avoid pressure damage and pressure-related symptoms.

Minimally invasive spine surgery uses only a tiny skin incision to insert the special surgical instruments and a microscope or camera. Compared to open surgery, which involves a larger opening of the surgical area, only a tiny amount of skin, muscle, and fatty tissue need an incision. This promises a faster healing process in the postoperative phase. This procedure can be used, for example, for narrowing of the spinal canal, herniated discs, and spondylolisthesis.

Welche Verfahren kommen zum Einsatz?

Es kann auf verschiedene Art und Weise minimalinvasiv an der Wirbelsäule operiert werden. Zum einen kann mittels spezieller Instrumente mikrochirurgisch operiert werden. Dabei wird ein Operationsmikroskop verwendet, welches den zu operierenden Bereich stark vergrößert und auf diese Weise die Sicht für den Operateur erleichtert. Durch Einbringen der Mikroinstrumente kann das zu operierende Areal behandelt werden.

Bei der minimalinvasiv-endoskopischen Methode wird anstatt des Mikroskops eine kleine Kamera in das Operationsareal eingeführt. Mithilfe der Übertragung dieser Kamera und kleinen Instrumenten kann die Operation durchgeführt werden.

Bei beiden Verfahren wird der Zugang mittels leichter Aufdehnung der Muskulatur anhand von Dehnstäben durchgeführt. Danach können die Instrumente und das Mikroskop bzw. die Kamera eingebracht werden.

Which Procedures Are Used?

Minimally invasive spinal surgery can be performed in various ways. On the one hand, microsurgery can be performed using special instruments. On the other hand, it involves using a surgical microscope that significantly magnifies the area to be operated on, making it easier for the surgeon to see. In addition, the area to be operated on can be treated by inserting the micro-instruments.

A small camera is inserted into the surgical area instead of the microscope in the minimally invasive endoscopic method. With the help of the transmission of this camera and small instruments, the operation can be performed.

In both methods, the access is carried out with slight musculature stretching using stretching rods. Then the instruments and the microscope or camera can be inserted.

For Which Spine Surgeries Can Minimally Invasive Procedures Be Used?

Minimally invasive surgery can be used for space-occupying lesions, inflammation associated with abscesses, and degenerative conditions. Degenerative, meaning wearing, conditions include narrowing at the spinal canal, herniated discs, chronic back pain, and vertebral body compression. The slipping of vertebral bodies, known as spondylolisthesis, can also be treated minimally invasively. In this case, the vertebral bodies are screwed together using special rods and screws that can be inserted into the surgical area through a small incision in the skin.

In chronic pain conditions, a heat probe can interrupt the pain fiber conduction and achieve freedom from pain. On the other hand, Herniated discs can be successfully treated with the micro-laser so that the bulging or prolapsed area of the disc is gently removed. Furthermore, endoscopic procedures can be used to examine the spine endoscopically to detect a possible disease process.

What Are the Advantages and Disadvantages of Minimally Invasive Spine Surgery?

A clear advantage of minimally invasive spine surgery is the shortened healing phase associated with faster wound healing. This can be explained by fewer large structures needing to be cut during the procedure, resulting in a smaller external and internal surgical scar. The "internal scar" in particular often leads to postoperative discomfort, which can be significantly reduced in this way.

Due to the reduced surgical trauma, early mobilization can take place, which offers some advantages for the patient in the healing process. On the other hand, prolonged immobile phases bring risks, such as thrombosis, muscle atrophy, and the difficulty of mobilizing elderly patients, which can be reduced with minimally invasive procedures.

Likewise, minimally invasive surgery puts less stress on the body and cardiovascular system, and there is usually less blood loss. Especially for more unstable and older patients, this type of surgery is significantly less risky and associated with a lower complication rate, especially for more unstable and older patients.

However, a disadvantage of minimally invasive surgery can be the poorer visibility that comes with a reduced surgical area. Working through small access is significantly more demanding, and the surgeon has more difficulty orienting himself in the surgical area and visualizing structures. In addition, if bleeding occurs, the view becomes even more complicated, and it may be necessary to open the surgical area more.

Which Doctors and Clinics Are Specialized?

Specialists in neurosurgery perform spinal cord surgery. Neurosurgical clinics that specialize in treating spinal disorders care for patients and provide inpatient care. There is an interdisciplinary therapy concept with neurologists, rehabilitation physicians, and physiotherapists.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively and a reliable doctor would never claim to be the best one, we can only rely on the doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in minimally invasive spine surgery and are awaiting your inquiry or request for treatment.

Sources:

• www.uniklinik-freiburg.de/neurochirurgie/schwerpunkte/wirbelsaeulenchirurgie/minimal-invasive.html
• Mikrochirurgie der Wirbelsäule, Krämer, Thieme Verlag
• orthopaede.com/therapien/minimalinvasive-wirbelsaeuleneingriffe/