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What is Minimally Invasive Spine Surgery?

Mark R. McLaughlin, MD, FACS, FAANS

Dr. McLaughlin discusses Minimally Invasive Spine Surgery. What exactly do we mean when we talk about MISS?

In this video education segment, Dr. McLaughlin explains the fundamentals of minimally invasive spinal surgery. This is an innovative, new 21st Century approach to spine surgery.

For many years traditional spinal surgery has 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 an open technique include that the large incision provides the surgeon with easy access to the spinal anatomy. The downside of an 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 time.

While in many instances open techniques are still preferred, more and more conditions are now being treated surgically, with new, minimally invasive spine surgery. As the name suggests, minimally invasive spine surgery allows the surgeon to make smaller incisions in the skin, and avoid a 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 incisions, and special surgical instruments are inserted through these tubes to perform the procedure.

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