Will Minimally Invasive Spine Surgery Ease Your Back Pain?

Smaller scars and a quicker recovery are benefits

woman holding her lower back

Do you need surgery for a back problem? Some conditions, including certain types of disc herniation and degeneration, can be addressed with minimally invasive spine surgery.

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“We use very small incisions with specialized instruments. This means that the procedure is often less painful than traditional spine surgery and leaves relatively small scars,” says Thomas Mroz, MD, Co-Director of Cleveland Clinic’s Center for Spine Health.

Other major advantages include:

  • A shorter hospital stay
  • Less narcotic use
  • A potentially shorter recovery time
  • Less pain

Different approaches, advantages

There are various approaches to minimally invasive spine surgery, which employ different tools.

These include an endoscopic approach, which employs a tiny camera and light attached to a flexible tube or surgery guided by an operating microscope. Lasers are used in some lumbar disc herniation cases, but not for most types of minimally invasive spine surgeries.

Minimally invasive techniques often work well in treating:

  • Lumbar and cervical disc herniation
  • Spinal stenosis
  • Age-related wear and tear on spinal discs (called spondylosis)
  • Bones in the spine that slip out of place onto the vertebra below (called spondylolisthesis)
  • Disc degeneration
  • Certain cases of scoliosis, an abnormal sideways curvature of the spine
  • Some less severe types of deformities

RELATED: Guide to Treating Scoliosis

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When is a minimally invasive approach not possible?

Not everyone is a good candidate for minimally invasive surgery. Many patients who have back pain associated with a spinal defect will require traditional open surgery, Dr. Mroz says. In traditional open surgery, the surgeon makes a larger incision and moves the muscles aside in order to work on the spine.

“Also, people with multi-level stenosis (a narrowing of the open spaces in your spine), previous spinal surgery or severe deformities cannot usually be treated with minimally invasive spinal surgery,” Dr. Mroz says.

Steps you can take to ease your recovery

Whether your surgeon will use minimally invasive or traditional open spine surgery, there are several things you can do before and after surgery to make your recovery easier.

  • Maintain a normal body weight (or lose weight if you are overweight).
  • Exercise. “Aerobic conditioning for months leading up to the surgery is helpful,” Dr. Mroz says.
  • Follow post-operative instructions your surgeon gives you.

Also, patients who are going to have spine surgery should not smoke.

“Smoking has major implications, not only for fusion surgery but also for your health in general,” says Dr. Mroz.

“We typically won’t perform a fusion on a patient who continues to smoke because we need a window of one to three months where the patient is smoke-free before the surgery. And, for fusion surgeries, the patient has to remain smoke-free for one year for the biological fusion to occur,” he says. 

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Choosing a surgeon

Dr. Mroz says that, although the allure of MISS may be strong, you should keep in mind that these are newer technologies.

“It’s important to pick an experienced surgeon who does minimally invasive surgeries as well as open surgeries in order to get a more robust evaluation and treatment plan,” he says.

“The same technique can’t be used for every problem, so you need to really think critically about the surgeon you’re choosing. Ultimately, you want a good outcome so you don’t have to go back for another surgery five years down the road. You want your surgery to be durable over time.”

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