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Minimally Invasive Spine Surgery: How it Works, Candidates for Surgery, & More

Author:  
Dr. Deuk
An expert in all things spine, Dr. Deukmedjain is a board certified neurosurgeon who has performed thousands of minimally invasive surgeries and procedures including the revolutionary Deuk Laser Disc Repair and the Deuk Spinal Fusion. 

Chronic back and neck pain can significantly disrupt your daily life. If you’ve exhausted non-surgical treatments and traditional surgery seems daunting, minimally invasive spine surgery (MIS) could be the answer. This innovative approach utilizes smaller incisions and specialized techniques to address spinal problems.

This guide will equip you with all the essential information about MIS. We’ll explore how it works, the potential benefits and risks involved, who qualifies as a candidate for this surgery, and what the recovery process entails. 

What is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery is a surgical technique used to address spinal conditions with less disruption to the muscles and tissues surrounding the spine compared to traditional open spine surgery. This approach utilizes smaller incisions, specialized instruments, and advanced imaging techniques to guide the surgery. The primary goal is to relieve chronic back and neck pain and restore function with minimal tissue damage, leading to quicker recovery times, reduced postoperative pain, and lower risks of complications.

Minimally invasive spine surgery can be used to treat a variety of spinal disorders, including herniated discs, spinal stenosis, spinal instability, scoliosis, and some types of spinal tumors. By preserving muscle and reducing the physical trauma typically associated with spine surgery, patients often experience faster rehabilitation and can return to their normal activities sooner.

Who is a candidate for minimally invasive spine surgery?

Candidates for minimally invasive spine surgery typically include individuals who:

  • Have a specific, identifiable source of pain or spinal issue that can be corrected with surgery, such as a herniated disc, spinal stenosis, or spinal instability.
  • Have not responded to non-surgical treatment methods, including physical therapy, medications, and injections, over a period of several months.
  • Are in generally good health and able to tolerate anesthesia and the surgery process.
  • Have realistic expectations about the outcomes of surgery, understanding that while MIS can alleviate symptoms, it may not always result in a complete cure for the underlying condition.

Who is not a candidate for minimally invasive spine surgery?

Individuals who may not be suitable candidates for minimally invasive spine surgery include those who:

  • Patients with severe or complex spinal conditions requiring extensive access
  • Individuals with certain health issues that could make surgery risky
  • People who have undergone prior spine surgeries with extensive scarring
  • Older patients who may have a harder time healing
  • Smokers, as smoking can increase clotting risks

It’s important to note that every case is unique. A doctor specializing in spine surgery can determine if minimally invasive surgery is right for you after considering your specific condition, medical history, and overall health.

Conditions Treated Using Minimally Invasive Spine Surgery

The following are conditions treated using minimally invasive spine surgery:

Herniated Disc

A herniated disc may lead to back or neck pain, discomfort in the arm or leg, and potentially evolve into more severe conditions such as radiculopathy, sciatica, or myelopathy. The term “discogenic” pain is used to describe discomfort stemming from a compromised disc.

The human spinal column contains 23 intervertebral discs. These discs serve as soft tissue joints, featuring a hydraulically gelatinous center known as the nucleus pulposus, which is encased in a tough outer collagen shell called the annulus fibrosus.

These discs play a crucial role in safeguarding the spinal vertebrae and nerves against abrupt impacts, besides absorbing shocks from various spinal activities like bending, jumping, and twisting.

However, the disc’s outer layer, the annulus fibrosus, is susceptible to traumatic injuries or tears (annular tear), which can allow the gel-like nucleus pulposus to protrude backward out of the tear into the spinal canal or neural foramen.

The segment of the gelatinous nucleus pulposus that protrudes through the tear is referred to as the herniation. Often, this herniation can press against a nerve, leading to the inflammation and irritation of the nerve involved.

Degenerative Disc Disease

Degenerative disc disease involves various structural, biochemical, nutritional, and molecular changes that occur within the spinal disc over time or after an initial injury to the intervertebral spinal disc in your spine.

Degenerative disc disease is a significant cause of back pain and neck pain (discogenic pain), along with sciatica, and radiculopathy. The pain in your back from degenerative disc disease originates from irritated (inflamed or compressed) nerve fibers in the vicinity and can be classified as mechanical instability.

Spinal Stenosis

Spinal stenosis occurs when, typically because of aging, the spinal canal becomes narrowed, exerting pressure on the crucial spinal nerves. The condition is referred to as cervical stenosis when it affects the neck region, thoracic stenosis in the middle to upper back, and lumbar stenosis in the lower back.

The narrowing can occur for various reasons, including the thickening of ligaments and cartilage within the canal or an increase in bone growth, leading the opening to gradually become narrower over time. The likelihood of encountering this issue escalates once an individual exceeds 50 years of age, partly because of the cumulative stress on the spine and the natural decrease in tissue and bone durability or flexibility after decades of use.

Additionally, bone disorders or injuries to the spine can lead to spinal stenosis in individuals of any age.

Types of Minimally Invasive Spine Surgery

The following are the various types of minimally invasive spine surgery:

Deuk Laser Disk Repair

Deuk Laser Disc Repair is a specialized form of endoscopic spine surgery and is the most advanced laser spine surgery in the world. It is used as an alternative to dangerous invasive surgeries like total disc replacement and spinal fusion.

Deuk Laser Disc Repair was developed by Dr. Ara Deukmedjian, a renowned neuro-spine surgeon and a true pioneer in minimally invasive, laser, and endoscopic back and neck pain treatment.  

Deuk Laser Disc Repair is performed in a state-of-the-art outpatient surgery center under sedation while the patient relaxes. This procedure does not compromise or weaken the health and integrity of the spine.

With a track record spanning over 15 years and more than 2000 patients treated, Deuk Laser Disc Repair boasts a remarkable 99.6% success rate, with zero complications reported.

Get a free MRI review from our team to see if you are good candidate for Deuk Laser Disc repair

Microdiscectomy

A microdiscectomy procedure is quite similar to discectomy surgery, but it utilizes a microscope for the operation and requires a 2-3 inch incision in the skin. This surgical technique involves the removal of disc material that has herniated and is exerting pressure on the adjacent nerve roots. 

To carry out this procedure, the surgeon makes a 2-3 inch incision over the area of the ruptured disc on the patient’s back. Following this, the surgeon then removes some bone and ligaments from the spine to access the herniated disc material after moving the muscle away from the spine. 

Typically, this approach is employed for individuals suffering from sciatica, which results from the compression of spinal nerves. It’s important to note that this procedure does not address back pain directly and can, in some cases, exacerbate it. 

Furthermore, many patients who undergo a microdiscectomy may experience a return of their symptoms within a year or two, requiring further surgeries to remedy the complications introduced by the initial microdiscectomy.

Laminectomy

During a laminectomy, the surgeon creates an incision on the patient’s back to reach the problematic vertebrae. Often described as “open decompression,” this procedure targets the lamina and associated ligaments, components of the vertebrae that constitute the vertebral arch located at the posterior (back) portion of the bone, aimed at addressing spinal stenosis. 

Once the surgeon gains entry to the affected vertebra, they proceed to excise the lamina and ligaments from the spine, alongside any bone spurs or fragments that might be compressing nerves. It’s important to note, however, that laminectomy and laminotomy procedures are not designed to alleviate back or neck pain and may, in some instances, exacerbate back pain.

Discectomy

There are two types of discectomy surgery that patients can undergo; an open discectomy or a microdiscectomy, which we reviewed above.

In an open discectomy, there’s a larger incision, and during this procedure, more of the normal spinal bone and ligaments are removed, leading to more scar tissue and pain compared to a microdiscectomy. 

This approach poses an increased risk of nerve damage to the nerves adjacent to the vertebrae. Furthermore, the spinal column may become unstable due to the removal of bones, ligaments, and facet joints. In such instances, a spinal fusion may be performed after the discectomy to restore stability to the spinal column, slightly extending the patient’s recovery period.

How is Minimally Invasive Spine Surgery Performed?

Minimally Invasive Spine Surgery is performed through small incisions using specialized surgical instruments, a microscope, and imaging techniques. This approach allows surgeons to access the spine with minimal disruption to the surrounding tissues. The surgery begins with the surgeon making one or more small incisions near the affected area of the spine. 

Through these incisions, thin tubes or retractors are inserted to create a passageway for the surgical instruments and a tiny camera, which sends images to a monitor that the surgeon watches during the procedure. This setup provides a detailed view of the operating area, allowing the surgeon to perform the necessary repairs with precision and control.

Let’s take a closer look at how it works for Deuk Laser Disc Repair: 

The procedure starts with a very small incision, less than a quarter-inch long. A cylindrical rod called a dilator is inserted through this small opening, gently spreading the muscle to create a passage and guide for the endoscopic surgery.

The tip of the dilator advances into the symptomatic disc through the annulus tear where the herniation originates, and a tube called the retractor slides over the dilator and is carefully positioned into the painful disc. The entirety of the Deuk laser disc repair surgery occurs inside this narrow tube.

An endoscopic camera is then inserted into the tubular retractor, allowing the surgeon to guide the laser inside each symptomatic disc precisely. This ensures that bones and surrounding tissues are not damaged, setting it apart from traditional spinal fusions, microdiscectomy, and artificial disc procedures.

The Holmium YAG laser used in Deuk Laser Disc Repair is manipulated with millimeter precision under endoscopic visualization to remove only the painful, inflammatory tissue from the disc, specifically targeting damaged disc material causing pain.

After the laser has removed the inflamed, painful portion of the annular tear and the herniated nucleus pulposus, the endoscope and tubular retractor are removed, leaving a less than one-quarter-inch incision in the skin, which is closed with a single stitch and a band-aid.

The total duration of the Deuk laser disc repair surgery is about one hour, with the patient spending roughly 45 to 60 minutes in recovery before being discharged to go home. This eliminates the need for hospitalization and the risks associated with hospital-based surgery.

Furthermore, Deuk laser disc repair does not result in a loss of normal movement, and the flexibility of the disc and joint is maintained. With endoscopic Deuk laser disc repair, there is no fusion, metal implants, or biological material added to the spine, making the procedure completely natural and allowing your body to heal the herniated or bulging disc naturally.

After the surgery, Deuk laser disc repair patients are able to go home, returning to normal activities promptly without pain. A significant benefit of Deuk laser disc repair is the absence of a need for opioids or powerful narcotic painkillers post-surgery.

Contrastingly, open spine surgeries like microdiscectomy, laminectomy, artificial disc replacement, and fusion cause substantial internal trauma, resulting in severe post-surgery pain and a dependency on painkillers for weeks, unlike with Deuk laser disc repair.

Hear directly from one of our patients just one hour after Deuk Laser Disc Repair, sharing their immediate improvement and quick return to daily life.

What to Know Before Minimally Invasive Spine Surgery

Before opting for minimally invasive spine surgery, you need to understand what the procedure entails, its potential benefits, recovery time and more.

How to Prepare for Minimally Invasive Spine Surgery

Here are some essential tips on how to prepare:

  • Consult and Understand: Discuss the procedure, expected outcomes, and risks with your surgeon. Understand the specifics of your operation, including targeted spine areas.
  • Medical Evaluations: Complete all pre-surgical tests (blood tests, MRIs, CT scans) for a comprehensive assessment of your spinal condition.
  • Pre-Surgery Physical and Nutritional Health: Engage in prescribed physical therapy to strengthen muscles for recovery. Adopt a nutritious diet to support healing and manage your weight.
  • Preparation for Post-Surgery: Arrange for post-surgery help and adjust your living space to minimize strain during recovery. Ensure easy access to necessities without bending or stretching.
  • Adhere to Pre-Surgery Protocols: Follow your surgeon’s guidelines regarding fasting, medication adjustments, and pre-operation procedures.
  • Mental and Emotional Prep: Employ relaxation and meditation techniques to address pre-surgery anxiety. Maintain a positive mindset and realistic expectations for recovery.

Minimally Invasive Spine Surgery Success Rate

The success rate of minimally invasive spine surgery varies depending on several factors, including the specific spinal condition being treated, the patient’s overall health, the surgeon’s expertise and the procedure being performed. Minimally invasive spine surgery such as Deuk Laser Disc Repair have a 99.6% success rate. Over 2000 patients have been treated with this procedure. While the complication rate of a cervical fusion is between 25-50%, the complication rate for lower back and basic spine surgery is between 5-50% (for Deuk laser disc repair, it’s 0%).

Minimally Invasive Spine Surgery Side Effects

Minimally invasive spine surgery is known for its benefits over traditional spine surgery, including reduced recovery time and minimized tissue damage. However, as with any surgical procedure, it has potential side effects and risks. 

These can vary based on the specific procedure, the individual’s health, and other factors, but some common side effects include infection, bleeding, nerve damage, and more.

Minimally Invasive Spine Surgery Recovery Time

Minimally invasive spine surgery recovery time is typically shorter than traditional open spine surgery. Most people can return to their normal activities within a few days or weeks.

Minimally invasive procedures such as Deuk Laser Disc Repair have a faster recovery rate (usually 45 minutes to an hour).

Minimally Invasive Spine Surgery Cost

The cost of minimally invasive spine surgery can vary widely based on factors such as the specific type of surgery, the surgeon’s expertise, geographic location, and whether the procedure is covered by insurance. To get accurate and up-to-date information on costs, it’s best to consult directly with healthcare providers and insurance companies.

Benefits of Minimally Invasive Spine Surgery

The following are the benefits of minimally invasive spine surgery:

Faster recovery

Patients typically experience quicker recovery times, allowing them to return to their daily activities and work sooner than with traditional surgery. 

Minimally Invasive

It involves smaller incisions and less disruption to the muscles and tissues surrounding the spine. This approach not only minimizes physical trauma but also contributes to the overall faster recovery process.

Lower risk of infection

Smaller incisions and reduced tissue exposure significantly lower the risk of postoperative infections. The minimally invasive approach limits the open surgical area, which decreases the potential for bacteria to enter the wound, leading to a safer recovery phase.

Risks of Minimally Invasive Spine Surgery

The primary risks associated with minimally invasive spine surgery include:

Infection

Despite the minimally invasive approach reducing the overall risk, there is still a possibility of infection at the incision site or within the deeper surgical area.

Bleeding

As with any surgical procedure, there is a risk of bleeding during or after the surgery. Although the risk is minimized due to the less invasive nature and smaller incisions, complications related to bleeding can still occur.

Nerve damage

The surgery involves working close to the nerves of the spine, and despite the use of advanced imaging techniques to minimize this risk, there’s still a possibility of inadvertent nerve damage.

While these are the risks of minimally invasive spine surgery, procedures such as Deuk Laser Disc Repair don’t carry any of these risks. Deuk Laser Disc Repair has a 99.6% success rate with 0 complications. 

Work with the best minimally invasive spine surgeon 

Choosing to undergo minimally invasive spine surgery is a significant decision that can greatly improve your quality of life. It’s crucial to select a surgeon and facility that are not only leaders in the field but also have a proven track record of success and patient satisfaction. The Deuk Spine Institute stands out as a premier destination for those seeking the best in minimally invasive surgery. 

With a team led by Dr. Ara Deukmedjian, a renowned neuro-spine surgeon and a true pioneer in minimally invasive, laser, and endoscopic back, neck, and thoracic pain treatment, Deuk Spine Institute offers unparalleled expertise and care.

At Deuk Spine Institute, patients receive personalized attention, from initial consultation through recovery, ensuring the highest standards of service and outcomes. By choosing Deuk Spine Institute, you’re not just opting for a minimally invasive procedure; you’re embracing a path to quicker recovery and a return to a life free of chronic pain.

Take the first step towards a pain-free life.

Cure your back and neck pain once and for all.

Deuk Laser Disc Repair has patients back on their feet within an hour, feeling zero pain
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About Deuk Spine Institute
World leader in Laser Spine Surgery
With world-class physicians on staff, the newest and most advanced technology, and a patient experience pathway that is unrivaled in it’s efficiency and and pedagogy of care, Deuk Spine Institute has performed thousands of procedures and achieves a 95% success rate in elimination of pain.

 The services we offer are not offered anywhere else in the world, and the treatments are curative, not palliative.  On top of that, Dr. Deukmedjian is personally invested in the well-being of each and every patient, and has spared no expense to guarantee the best possible outcomes.
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