Minimally Invasive Decompression

Definition

Minimally invasive spine surgery for decompression is a surgical technique to cause minimal trauma to the superficial structures of the spine, such as the skin, muscles, and ligaments. This procedure is typically done in the lumbar, i.e. lower back area. It is typically done for a condition called lumbar spinal stenosis, which is a result of a chronic, degenerative process of wear and tear on the joints of the spine. Stenosis causes symptoms of pain and/or numbness and tingling, possibly weakness in the legs with prolonged standing or walking. The condition is typically diagnosed by MRI scan, and/or lumbar myelogram CAT scan.

Surgical Procedure

The procedure is performed under general anesthesia. The incision is about 1 inch. Dilator devices are passed through the tissues and muscles down to the surface of the spine. Then a hollow tubular retractor, 18 to 20 mm in diameter, is passed through the dilated path down to the surface of the spine. Spine surgery then proceeds to open the spinal canal to relieve the stenosis by removal of abnormal thickened ligaments, structures, and bone. The result is relief of pressure on the nerves and the spine. This can be performed on just one side or both sides through one incision and one surgical approach. Minimally invasive spine surgery requires special surgical instruments, designed to work down the narrow tubular retractor. Visualization down the tube is performed with a microscope, a camera, or an endoscope.

The procedure is performed either as a day surgery, or a one-night hospital stay, depending on the extent of the surgery and associated medical conditions.

Advantages over open surgery include a much smaller incision and much less dissection of the muscles, therefore minimizing postoperative incisional pain and muscle spasm. This results in a shorter length of stay, early resumption of activities, such as walking, driving, and activities of daily living.

Complications basically the same as open surgery as far as infection, spinal fluid leak, nerve injury, or hemorrhage into the surgical site. The overall risk of occurrence of these complications is quite low. Most people enjoy a quick recovery and satisfactory relief of their preoperative symptoms. 


To view the animation Minimally Invasive Lumbar Microdecompression, click here.

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