For many years, traditional spinal surgery has usually involved making
a large incision up and down the middle of the back, and spreading apart
(or retracting) the back muscles to access the spine. This is commonly
referred to as an "open" technique. The advantages of open techniques
include the large incision provides the surgeon with easy access to the
spinal anatomy. The downside of "open" spine surgery is that the muscle
retraction damages the spinal muscles and can cause significant post-operative
pain. In addition, such surgery results in significant blood loss, a large
scar and relatively long recovery times.
While in many instances "open" techniques are still preferred,
more and more conditions are now being surgically treated using new techniques
called minimally invasive spine surgery.
What is minimally invasive spine surgery?
As the name suggests, minimally invasive spine surgery allows the surgeon
to make smaller incisions in the skin and avoid large muscle retraction.
The surgeon uses a thin telescope-like instrument, called an endoscope,
which is inserted through a small incision. A tiny video camera and light
are connected to the endoscope and send images from "inside"
the body to a screen in the operating room. Small tubes are then inserted
through other small incisions. Special surgical instruments are inserted
through these tubes and used to perform the surgical procedure.
Advantages of minimally invasive techniques
Minimally invasive spine surgery generally results in the same surgical
outcome as with more traditional techniques. However, there are a number
of advantages to minimally invasive techniques, including:
CCSI's Use of Minimally Invasive Techniques
- Reduced operative times.
- Less soft tissue damage, due to reduced muscle retraction.
- Surgical incisions are less painful.
- Reduced blood loss.
- Recovery is faster with less post-operative pain.
- The hospital stay is shortened.
- Since incisions are much smaller, scaring is less noticeable and cosmetically
At CCSI, our priority is providing the best care for our patients. For
this reason, we offer a variety of minimally invasive techniques that
we feel are scientifically proven, but we avoid others that remain unproven.
The minimally invasive techniques CCSI offers include:
- Discectomy - Discectomies involve the removal of intervertebral discs.
At CCSI we do many discectomies minimally invasively. We use the METRx
Microdiscectomy System, which allow us to use small incisions to access
the spine and to perform the discectomy.
- Anterior Lumbar Interbody Fusion (ALIF). A traditional approach for
an ALIF procedure involves significant soft tissue damage and blood loss.
At CCSI we utilize a mini-open approach for ALIF. This is a far less
invasive procedure than the traditional approach, but is also safer than
the laparoscopic technique.
- Posterior Lumbar Interbody Fusion (PLIF). We utilize a mini-open PLIF
technique for such conditions as spondylolisthesis and degenerative disc
disease. In fact, spine surgeons now use the retractor system we developed
for this technique across the United States.
- Endoscopic PLIF CCSI is proud to be one of a very small number
of centers across the US who is part of a study testing and developing
this state-of-the-art technique.
- Pedicle screws Until recently, the insertion of pedicle screws
has required the surgeon to expose the pedicles. Today, at CCSI we use
a device called SEXTANT that allows us to implant pedicle screws
through the skin without disturbing muscles and tendons.
- Vertebroplasty and Kyphoplasty These relatively new procedures
are used to treat vertebral compression fractures by injecting orthopedic
cement into the affected vertebrae. At CCSI we have considerable experience
with these techniques, and excellent outcomes.
CCSI only adopts new techniques when their safety and quality are
clearly proven. However, once these proofs have been provided, CCSI
is at the forefront of adopting new technologies and techniques for
the benefit of our patients.