Minimally Invasive Spine Surgery in South Denver and Littleton

To relieve back pain and dysfunction, minimally invasive spine surgery uses a small incision and muscle-sparing techniques to target the problem area with less damage to nearby tissue. 

 

Spine Function and Dysfunction

The bones and nerves of the spine are designed to be good neighbors. Each vertebra of the spine surrounds and protects the spinal cord and spinal nerves. These nerves branch off from the spinal cord through openings in the vertebrae to communicate with the rest of the body, regulating movement and sensation.

Spongy discs lie between vertebrae to cushion the spine, and tiny holes and passageways in the bones allow the nerves and spinal cord to pass through. When problems with the spine interfere with the peaceful coexistence of the bones and nerves, it can lead to symptoms such as pain, numbness and weakness affecting the back, neck, arms or legs.

Spinal conditions that may, in some cases, be treated by minimally invasive spine surgery include:

  • Degenerative disc disease—occurs when soft tissue inside a spinal disc bulges out of place, irritating nearby nerves. You may be told you have a herniated disc, disc bulge, disc extrusion or disc protrusion.
  • Radiculopathy—a compressed nerve in the spine; may also be called a pinched nerve. Sciatica is a lay term for a type of low back (lumbar) radiculopathy.
  • Spinal stenosis—a narrowing of the spinal canal or exitways that can cause nerve compression
  • Spondylolisthesis—a condition in which a vertebra slips forward out of its proper position above the bone below it

Conservative treatments, such as physical therapy, medication and injections, can often relieve pain and other symptoms of spinal dysfunction. However, surgery may be necessary if symptoms continue to interfere with normal functioning.

When surgery is performed to remove part of a bone or spinal disc to relieve pressure on the spinal cord or nerves, it is called decompression surgery. A spinal fusion creates a solid union between two or more vertebrae to strengthen and stabilize the spine. When possible, both decompression and fusion surgeries can be performed with a minimally invasive technique.

 

How Minimally Invasive Spine Surgery Works

Some patients wonder if minimally invasive spine surgery is experimental, but it has actually been around for quite some time, explains Ben Guiot, MD, neurosurgeon formerly with South Denver Neurosurgery.

Originally popular in the United States among Las Vegas dancers as a way to minimize scars, a minimally invasive approach proved to have benefits more compelling than just the cosmetic. “The purpose of minimally invasive spine is to decrease the risks of surgery and decrease the damage to the tissues we’re working with,” Dr. Guiot explains.

In traditional open spine surgery, there is an incision down the middle through which the muscles are pulled off the bone so the surgeon can access the spine. The affected muscles can be damaged and weakened from being cut through. Some research suggests the disruption to surrounding tissue may increase the risk of future problems in nearby areas of the spine, called adjacent level disease.

By contrast, minimally invasive spine surgery uses a muscle-preserving technique, dilating the muscles instead of cutting through them. “We’re on a stealth mission just down to the level we want to operate on,” Dr. Guiot says. A series of tubes called tubular retractors progressively spreads apart the muscles until the surgeon has a small hole to work through. Specially designed surgical instruments are used to allow the surgeon to see and work in the narrow surgical field.

The benefits of minimally invasive spine surgery can include:

  • Smaller incision
  • Shorter operative time
  • Decreased blood loss
  • Less muscle damage
  • Reduced incidence of infection
  • Less post-surgical pain and faster recovery

Minimally invasive spine surgery is most commonly performed on the low back (lumbar spine). The spinal cord does not run through the lumbar spine, so surgeons are only maneuvering around spinal nerves, not the spinal cord itself. The neck (cervical spine) is the next most common location for minimally invasive surgery.

 

For Patients to Consider

The benefits of minimally invasive spine surgery can affect outcomes and complications. For lumbar decompression, research suggests minimally invasive and open procedures may have similar outcomes. Complications result in less significant problems for patients in the minimally invasive group. For fusion, minimally invasive techniques are superior in outcome and complication rates.

While minimally invasive spine surgery is easier on the patient, it’s actually harder for the surgeon. Because of the challenge presented by operating through a smaller working channel, it’s important to find a surgeon who is trained and experienced in minimally invasive surgery techniques.

Not everyone can or should have minimally invasive spine surgery, Dr. Guiot says. For example, a fusion surgery of more than three levels is too complex to perform minimally invasively. Talk to your spinal surgeon to find out what surgical approach is best for you and your condition.

Also, laser spine surgery can be promoted as minimally invasive spine surgery. However, it is a new and investigational procedure that is not offered at South Denver Neurosurgery. It is rarely paid for by insurance and is not well regarded by board-certified spine surgeons.

Questions to ask a potential surgeon:

  • Will my spine surgery be done minimally invasively? If not, why not? If so, what is minimally invasive about it?
  • Are you using a muscle-sparing technique? How are you limiting damage to adjacent structures?
  • How many of these types of procedures have you done? How often do you do them?

 

Watch a video about minimally invasive spine surgery: