5 Key Things to Know about MIS Fusion

5 Key Things to Know about MIS Fusion
January 13, 2016

When people with chronic back pain hear the term “spinal fusion,” many think a big, complicated operation is involved. But minimally invasive spinal fusion surgery, also known as MIS fusion, offers big results without an elaborate procedure and helps chronic back pain sufferers to quickly resume their daily and recreational activities, according to Praveen Kadimcherla, MD, an orthopedic spine surgeon at Atlantic Spine Center.

Unlike traditional “open” spinal fusion, which uses a long incision to access spinal structures, MIS fusion requires much smaller cuts, allowing surgeons to achieve comparable results with much less pain and a more rapid recovery.

But much confusion about the procedure still abounds. Here, Dr. Kadimcherla, who completed two spinal surgery fellowships in Orthopaedics and Neurosurgery and is a published author on spine disorders and treatment, explains 5 key things to understand about MIS fusion:

What is MIS fusion surgery?

Performed since the 1990s, MIS fusion corrects problems with the vertebrae – the small bones of the spine – by fusing together painful vertebrae so they heal into a single, solid bone. This helps vertebral bones stop “grinding” together, which can cause bone spurs, arthritis and other pain-producing problems.

Who’s a candidate for MIS fusion?

This type of surgery is typically recommended for patients suffering from lingering back pain from a variety of causes, including lumbar degenerative disease, which causes radiating pain from damaged discs in the spine; recurrent lumbar disc herniations, which occurs when the jelly-like center of a disc bulges between vertebrae and presses on nerves; spondylolisthesis, in which one vertebrae slides forward over another below it, squeezing nerves; or foraminal stenosis requiring disc height restoration, a narrowing of spine openings resulting in nerve compression.

How is MIS fusion surgery performed?

MIS fusion surgery is performed with special tools known as tubular retractors, which are inserted into a small incision and through soft tissues to the designated spot on the spine causing pain. The retractor holds muscles open while a surgeon removes any offending tissue and sets devices in place that will fuse vertebrae, such as screws or rods. The surgeon’s planned approach to the spine – through either the patient’s back or the side – determines the exact procedure and its specific name (common MIS fusion names include XLIF, TLIF and OLLIF.

What does recovery from MIS fusion surgery involve?

Unlike traditional spine fusion surgery, MIS fusion doesn’t require any hospital stay. Blood loss is minimal and patients are up and walking on the same day, Dr. Kadimcherla notes. Instead of a recovery lasting 6 months or longer, most MIS fusion patients can return to normal activities in 4 to 6 weeks. Driving can resume after any post-operative pain has reached a mild level, which is usually in 7 to 14 days. After the initial recovery, many patients will be recommended for a series of physical therapy sessions to help strengthen back muscles and improve flexibility.

What are the advantages of MIS fusion?

The benefits of MIS fusion are many, including less blood loss during surgery and a reduced need for blood transfusions using the minimally invasive technique. Often, patients require less pain medication following this form of surgery as well, Dr. Kadimcherla says.

“But perhaps the biggest advantage of MIS fusion is that it stops the abnormal motion between spinal vertebrae with a technique producing much less damage to surrounding tissues than an open surgery,” he adds. “Instead of cutting and moving muscles, MIS fusion more gently spreads muscles, allowing ready access to the spine. This is much less painful for the patient and doesn’t require as long for muscles to heal.”

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