Having Minimally Invasive Spine Surgery

Minimally invasive spine surgery (MISS) is a type of surgery on the bones (vertebrae) of your spine. This type of surgery uses smaller cuts (incisions) than standard surgery. This often causes less harm to nearby muscles and other tissues. It can lead to less pain, reducing the need for pain medicines. This type of surgery can also reduce blood loss and scarring, and allow a faster recovery.

Surgeons can use MISS for some types of spine surgery. These include:

• Lumbar diskectomy

• Laminectomy

• Spinal fusion

What to tell your healthcare provider

Tell your provider about all the medicines you take. This includes prescription and over-the-counter medicines, such as ibuprofen. It also includes vitamins, herbs, and other supplements. Also tell your provider if you:

• Have had any recent changes in your health, such as an infection or fever

• Are sensitive or allergic to any medicines, latex, tape, or anesthesia (local and general)

• Are pregnant or think you could be

Tests before your surgery

Before your surgery, you may need imaging tests. These may include an ultrasound, X-rays, or MRI.

Getting ready for your surgery

Talk with your healthcare provider about how to get ready for your surgery. You may need to stop taking some medicines, such as blood thinners and aspirin, before the procedure. If you smoke, you may need to stop before your surgery. Smoking can delay healing. Talk with your provider if you need help to stop smoking.

Also make sure to:

• Ask a family member or friend to take you home from the hospital

• Follow any directions you're given for not eating or drinking before surgery

• Follow all other instructions from your provider

You'll be asked to sign a consent form. It gives your permission to do the procedure. Read the form carefully. Ask questions before you sign the form if something isn't clear.

On the day of your surgery

MISS is done by an orthopedic surgeon or neurosurgeon and a trained care team. The details of MISS vary depending on what part of the spine is being treated and other factors. Your surgeon can help explain what to expect for your surgery. The following is an example of how MISS is done:

• You may have a type of anesthesia that numbs part of your body. You’ll also be given sedation. This medicine will make you relaxed, but you'll still be awake during surgery. Or you may be given general anesthesia. This medicine prevents pain and causes you to sleep through the surgery.

• A healthcare provider will carefully watch your vital signs, like your heart rate and blood pressure, during the surgery.

• You may be given antibiotics before and after the surgery. This is to help prevent infection.

• During the procedure, the surgeon will use a type of X-ray to view the surgery.

• The surgeon will make a small incision on your back in the area that needs to be treated. They'll put a tool called a tubular retractor into this incision. This tool lets the surgeon reach the part of the spine to be treated.

• The surgeon will then pass small tools through this retractor. This may include a tiny camera and a light.

• The surgeon will then make the needed repairs to the spine.

• When the repairs are done, the surgeon will take out all the tools. They'll close the incisions with stitches, glue, or staples. A small bandage is put on the wound.

After your surgery

Some types of MISS can be done as an outpatient procedure. This means you can go home the same day. You'll need to stay for a couple of hours after the procedure. This is so your healthcare team can watch for problems. Or you may need to stay 1 or more nights in the hospital. When you’re ready to go home, you’ll need to have someone drive you.

Recovering at home

You'll have some pain after the surgery. This can be relieved with pain medicine. Ask your healthcare provider if there are any pain medicines you shouldn't take. Often the pain will go away quickly.

Your provider will tell you how to use your back safely after surgery. You may need to limit lifting or bending. You may need to wear a back brace for a time. And you may need physical therapy after the surgery. This is to help strengthen muscles around the spine and help you heal. Your recovery time will depend on the type of surgery you had and your general health. You may be able to go back to normal activities in a few weeks.

Follow-up care

Make sure to follow all instructions about follow-up treatment and appointments. This will help make sure the surgery works well for you.

When to call your healthcare provider

Call your provider right away if you have any of these:

• Fever of 100.4°F ( 38°C) or higher, or as advised by your provider

• A lot of fluid leaking from the incision site

• Symptoms that don’t get better or new symptoms that concern you

• Weakness, trouble urinating, or loss of sensation

• Pain that is getting worse