Minimizing trauma during minimally invasive spine surgery (MISS) can be done with a variety of methods. Common MISS techniques include:
• Surgery using tubular reactor – Instead of cutting directly through the muscles, this technique involves progressive dilation of soft tissues. The surgeon works through the incision with the help of tubes that keep the muscles out of the way. This eliminates the need to widely expose the area. An endoscopic or microscope may sometimes be focused down the tube to assist with the surgery. The tubular retractor is removed after the procedure to allow the dilated tissues to return to their original position. Incisions may be small depending on the extent and the type of surgery.
• Screws/rods percutaneous placement – Rods and screws may be placed to stabilize or immobilize the spine during fusion. Traditionally, screw placement involves extensive muscle and tissue removal from the spine surface. Percutaneous, or through the skin, involves inserting rods and screws into small skin incisions without cutting or dissecting the underlying muscle. Guide wires are positioned through the skin and spinal vertebrae with the help of x-ray images. After that, the screws will be placed over the guide wires following the path. The screw’s temporary extenders are removed once the screw are connected and secured.
• Direct lateral access routes – In some cases, your spine may need to be accessed from the side, especially if it involves the lumbar spine. The surgery entails having the patient lay on his or her side. A tubular retractor is positioned on the side of spine so the surgeon can have access to the spine’s discs and bones.
• Thoracscopic access route – Depending on the situation, the front portions of a patient’s thoracic spine may need to be accessed. The thoracic spine is located in the chest and is surrounded by the heart and lungs. Traditionally, this involves creating a large incision and even rib removal. Now, however, this can be accessed through multiple small incisions where ports and cameras are inserted.