At TN Brain and Spine we perform minimally invasive spine surgery that offers our patients many advantages, including a smaller incision, less post-operative pain, reduced risk of surgical complications, and a faster recovery.
Our Quality Data
- Our minimally invasive spine center performs more than 300 elective surgeries each year, and 93% of patients who stay overnight in the hospital are able to go home after surgery instead of to a rehab hospital or nursing facility for recuperation.
- Unlike traditional surgeries that may require blood transfusions, more than 99% of our minimally invasive spine surgery patients do not need transfusions.
- 100% of our cervical and lumbar patients who undergo fusions have experienced no post-surgical infections.
Frequently Asked Questions about Minimally Invasive Spine Surgery
What is minimally invasive spine surgery (MISS)?
Traditional spine surgery is performed through larger incisions ranging from two to six inches with extensive muscle dissection and spinal exposure, but evolving minimally invasive techniques have made it possible to perform many spine and neck surgeries through one or more small incisions that are only one-half to one inch long. Minimally invasive spine surgery offers patients many advantages, including less post-operative pain, reduced risk of surgical complications, and a faster recovery.
What conditions can be treated with MISS?
We treat the following spine conditions with minimally invasive surgery:
- Compression or trauma to the sciatic nerve
- Herniated or ruptured discs
- Degenerative disc disease
- Spondylolysis – a crack or stress fracture of the spinal vertebrae
- Spondylolisthesis – instability of the spinal vertebrae
- Stenosis – narrowing of the passageways between vertebrae
- Small spinal canal tumors
What types of surgery can be performed using minimally invasive techniques?
- Anterior Cervical Discectomy and Fusion
- Anterior Lumbar Interbody Fusion for Degenerative Disc Disease
- Minimally Invasive Lumbar Discectomy
- Minimally Invasive Lumbar Fusion for Spondylolisthesis
- Minimally Invasive Posterior Cervical Discectomy (Foraminectomy)
- Minimally Invasive Thoracic Discectomy
- Minimally Invasive Laminectomy for Spinal Stenosis
- Surgery for Spinal Tumors
How long is the average recovery period after an outpatient MISS procedure?
Some procedures can be performed as an outpatient procedure, including disc herniations or spinal stenosis, and patients are typically discharged home within two to three hours after surgery. The average hospital stay is less than two days, and most patients can return to activities of daily living and work within one to four weeks. Return to work varies from 1 to 3 months depending on the type of surgery and the physical demands of your employment. Postoperative pain is easily managed in most patients with oral medication.
What is meant by spinal instability or spondylolisthesis?
Spinal instability refers to excessive movement between two vertebrae resulting in a misalignment of the vertebrae. This misalignment is called spondylolisthesis and may cause spinal stenosis and pinched nerves.
What does lumbar or spinal instrumentation mean?
It refers to the use of titanium screws and rods to surgically stabilize an unstable segment of the spine and promote fusion of the affected vertebrae. The rods and screws are used in conjunction with techniques to fuse the unstable vertebrae together.
If I have a fusion why do I need rods and screws in my spine?
If you break an arm or leg you must wear a cast to keep the broken bones aligned while they grow together. Screws and rods in the spine serve the same purpose as a cast on a broken arm or leg. They maintain constant contact between the vertebrae and the bone grafts to promote the fusing together of the vertebrae.
Can you feel the rods and screws after surgery?
The four screws and two rods are approximately one-fourth inches in diameter and two to three inches under the back muscles. Only an extremely slender patient with small back muscles might be able to feel the heads of the screws. We have seen this occur one time in over 800 cases. In that patient, the screws were removed after the fusion matured.
Do the rods and screws need to be removed?
No. As long as solid fusion occurs after surgery, the rods and screws will remain in place. This is true for patients undergoing short segment fusions and may not apply to patients undergoing more extensive fusions for problems such as scoliosis.
Do you use a laser?
There is no evidence in the surgical journals to justify the use of lasers in spine surgery. The term “laser” is frequently used as a marketing ploy to attract patients with spine disease who may need surgery. We do not use a laser for spine surgery because there is no advantage for the patient over current minimally invasive techniques and instruments. The laser is simply a cutting tool.
When a surgeon removes a herniated disc the surgeon must work under, between, and around nerves to remove herniated disc fragments in the spinal canal. Laser light energy cannot be bent. It won’t work around a corner or reach under or around nerves. It requires skilled hands and specialized minimally invasive instruments to perform this type of surgery through small incisions. Attempting to do this with a laser would, in our opinion, greatly increase the risk of nerve damage.
Also, performing a laminectomy requires removal of bone. Lasers will not cut or evaporate bone and cannot be used for this procedure.
In summary, spine surgeries such as lumbar discectomy, laminectomy, or spinal fusion cannot be performed with a laser as a primary surgical instrument. A surgeon could conceivably make part of the incision with a laser but there would not be any additional benefit to the patient.
If your question was not answered in this list of frequently asked questions, or for more information about the neurosurgical services at TN Brain and Spine, call (865) 331-2835.
No referral is necessary unless required by your insurance provider.