In our opinion, minimally invasive surgery on the spine involves tubular retractors. This provides a smaller incision, less damage to muscle and soft tissues, lower complications and better results in our hands.
A “smaller incision” does not necessarily mean a procedure is minimally invasive. Some surgeons can make a slightly smaller scar, but do not use a tubular retractor to spread the muscle. These surgeons still detach the muscle from the bone causing muscle damage and potentially facet joint injury.
Stem cell therapy image and Information from ipscell.com.
Anterior and lateral surgical approaches can be used in spine fusions and artificial discs, but this also does not necessarily mean a procedure is minimally invasive. Anterior and lateral approaches may avoid damaging the back muscles, however they still risk damage to abdominal organs, large blood vessels and possibly anterior spine muscles. In comparing anterior fusion to tubular minimally invasive fusion:
- Infection and blood clots may be increased in anterior approach patients
- There tends to be a longer hospital stay in anterior approach patients
- There tends to be increased blood loss from major blood vessel injury in anterior approach patients
- Readmission (admitted back to the hospital) odds may be increased in anterior approach patients
- Cost may be higher in anterior approach patients
Mid and low back fusion procedures can be performed now using a robot such as the Mazor. This type of robot may be used along with tubular minimally invasive procedures, but using the robot by itself does not necessarily mean the procedure is minimally invasive. Additionally, major nerve and spine injuries have been reported in using the robot due to errors in technology.
Stem cells treatment is not necessarily a minimally invasive technique. Stem cell procedures are not thought to be effective currently. They are not FDA approved and commonly require cash payment.
Laser spine procedures can be performed using minimally invasive techniques, but minimally invasive spine surgery may be more effectively performed without a laser.
- Lasers are straight beams which do not work well around corners
- Lasers emit heat
- Lasers cannot easily control depth
- The reoperation rate with lasers is reported to be higher than with traditional minimally invasive surgery
- Laser treatment tends to require cash payment.
Our surgeons at Rocky Mountain Brain & Spine institute are BOARD CERTIFIED and perform tubular minimally invasive spine procedures.