Since nearly 8 and 10 adults will suffer from lower back pain at some point in their lives, and a number of them can’t find relief through conservative treatments, it’s useful to understand what this increasingly popular surgery can do.
If chronic back or neck pain has lingered for months despite trying medication, physical therapy or other conservative measures, you may be wondering if spine surgery could fix the problem. But the prospect of surgery – even using minimally invasive techniques – usually triggers another set of questions patients need answered, according to Fabien Bitan MD, an orthopedic spine surgeon at Atlantic Spine Center.
While minimally invasive spine surgery (MISS) was developed more than two decades ago to treat a host of underlying conditions triggering back pain, most people have little idea of what the procedure entails and how it could impact and improve their lives, Dr. Bitan says.
“The idea of minimally invasive spine surgery isn’t even on most people’s radar until they or a loved one is coping with back or neck pain day after day, week after week,” explains Dr. Bitan. “But since nearly 8 and 10 adults will suffer from lower back pain at some point in their lives, and a number of them can’t find relief through conservative treatments, it’s useful to understand what this increasingly popular surgery can do.”
Here, Dr. Bitan answers some of the most frequently asked questions (FAQs) about MISS:
Am I a good candidate for MISS?
If your back or neck pain has persisted for 6 to 12 months despite trying numerous non-operative treatments, then MISS may be for you. It treats specific conditions such as spinal stenosis, sciatica, spondylolisthesis or herniated discs that can be pinpointed using various diagnostic and imaging tests. “Certain spine conditions require standard ‘open’ surgery using longer incisions, such as high-degree scoliosis, tumors and some infections,” he says.
How is MISS performed?
The technology used in MISS is compelling, Dr. Bitan says. Using cuts of only an inch or less in length, surgeons access the spine using small tools called retractors, which are placed into the tiny incision and through soft tissues to the designated spot on the spine. Any bone or disc material removed comes through the retractor, and any devices necessary for fusion procedures – which fuse together painful vertebrae so they heal into a single, solid bone – are also inserted through this space. Since such a small incision is used, the surgeon doesn’t have to move, remove or alter major muscles, normal bone structures, or nerve bundles. Most MISS procedures take 90 minutes or less.
How quickly will I recover from MISS?
Faster than you think, Dr. Bitan says. Because MISS is minimally disruptive to tissues surrounding the spine, the procedure is often done on an outpatient basis and recovery is swift. Many patients are able to get up and walk right after surgery with minimal pain and go home within a few hours (spinal fusion surgeries may require a 2-3 day hospital stay). Going back to work can occur within 1-2 weeks or just slightly longer, and some patients return to full activity within 6 weeks.
Will I need physical therapy after MISS?
Not necessarily, but probably, Dr. Bitan says. It depends on the patient, but physical therapy to strengthen muscles surrounding the spine and improve flexibility is often initiated 2 to 6 weeks after surgery. “Patients often find that physical therapy hastens their overall recovery and makes them feel better even quicker,” Dr. Bitan says.
What are the advantages of MISS?
“The benefits of MISS compared to open surgery quickly add up,” Dr. Bitan says, including better cosmetic results from smaller incisions; less blood loss and a lower risk of needing a blood transfusion; a reduced risk of muscle damage; lower risk of infection and post-operative pain; and less need for pain medications after surgery.
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