Princeton's Ask The Doctor July/August 2018

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Minimally invasive spine surgery developed over time and the first trials date back to the 1980s. These were first done with endoscopic cameras that sacrificed some sense of three dimension. We progressed to small tubes through which we visualize spinal anatomy with magnification. Traditionally spine surgery was done through longer incisions and muscle was cut into or stripped off it’s attachment to the bone. Powerful metal devices are then placed to hold the wound open to allow the surgeon access to the spine and all of this causes damage to the muscle. Today, the great majority of spine surgeries can be performed through slender tubes. After making a small incision, usually under an inch in length, we place a thin probe through the muscle down to the spine. We then slide slightly larger tubes over the probe spreading the muscle fibers gently apart. When we are done with the procedure, the tube is pulled out and the muscle falls back together, causing minimal damage to the muscle. Research has also determined that minimally invasive surgery results in lower blood loss and lower infection rates. Recent literature has shown better patient overall results at two and four years after minimally invasive surgery in comparison to an open procedure. Question: What is meant by minimally invasive spine surgery and what are the advantages? Answer:

Larry Deutsch, MD Dr. Deutsch is a board-certified orthopedic surgeon who has specialized in spine surgery for more than 25 years

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JULY/AUGUST 2018