By Michael Glover, MD, MBA, Orthopaedic Spine Surgeon at NAO
(Originally featured in the Flagstaff Business News on Nov. 26, 2018 in Columnists)
Patients come to see me for a variety of complaints regarding their back and neck health. Often, there are specific questions they would like me to answer (often, to help debunk Google), and end up sharing so much about their back pain, which is incredibly personal and can really impact one’s life in a variety of ways. Naturally, my surgical patients usually ask me about the least-invasive, minimally painful and easiest surgery for them to undergo, so they can get back to enjoying life again. These conversations often land on questions surrounding minimally invasive spine surgeries, or MISS for short.
What is a Minimally Invasive Spine Surgery (MISS)?
I usually explain it this way: the term “minimally invasive” refers to a surgery that minimally invades the soft and hard parts of the back to gain access to the cause of the pain and treat it. There are many ways to accomplish minimally invasive spine surgery through specialized approaches that spare the muscles of the spine and preserve the bony parts. One way to accomplish this is inserting specialized instruments and a video camera through small incisions in the back, allowing for visualization of nerves that are being compressed. The special type of MISS now offered in Flagstaff is called Endoscopic Spinal Surgery and I have been seeing – and my patients are experiencing – great success with it.
What Does Endoscopic Mean?
Endoscopic basically means to “look within” a body cavity or space and in this case, “look within the spine.” Thus, Endoscopic Spine Surgery is a state-of-the-art MISS that uses a small, less than ½-inch incision made to insert a tube that creates a safe working channel for a specialized video camera (the endoscope) to help see the anatomy. This type of visualization allows for images from “inside” the spine to be seen by the surgeon as they show on a large screen. The endoscope also serves to host the specialized instruments used to work on the problem area causing the nerve pain. Using the endoscope, I can directly view the problem and surgically remove the disc material or abnormal tissue in the spine.
Endoscopic Spine Surgery is the ideal surgery for the right patient with sciatic-like leg pain due to disc herniations, or other problems that compress nerves and have not responded to non-operative treatments. This type of surgery preserves normal spine mobility and most patients can be discharged from the recovery room with minimal pain from the procedure and immediate relief of the sciatic pain. Overall, the surgery makes for a very positive patient experience and outcome.
Advantages of a MISS Over a Traditional Spine Surgery
I have found the biggest advantage of having this type of Minimally-Invasive Spine Surgery (MISS) is a much quicker recovery and less pain than traditional spine surgery for my patients. The other benefits tend to range from minimal skin, tissue and muscle trauma, to overall fewer complications, allowing for most patients to get up and walk, then go home the very same day as surgery. Probably the most notable element of this revolutionary surgery is the size of the incision sites – they are the size of a dime and can be covered by a single Band-Aid, hence the trending name in the spine industry, the Band-Aid Back Surgery.
I explain the advantages of minimally invasive endoscopic surgeries to patients in this way:
- Less than a centimeter incision on their back
- Zero blood loss
- More rapid recovery
- Fewer pain meds
- Preservation of spinal mobility
- Same-day home after surgery
- High success rates with low complications
A typical endoscopic spine surgery is done in an outpatient surgery setting. The approach is through the small opening on the side of the spine where the nerves exit and uses a small centimeter-sized skin incision. This is where the camera or scope is inserted. A surgeon can also approach from the back of the spine and in between the lamina (the boney part of the spine that covers the main nerve canal). Either approach is considered minimally invasive.
Endoscopic spine surgery is an exciting treatment for people with lumbar spine disorders particularly related to disc herniations who have not responded to non-operative care. Most of the patients I treat with this surgery have nerve compressions, and pain relief will come when I decompress the nerves on the spine. FBN
By Michael Glover, M.D., MBA
Endoscopic Spine Surgery recently became available in Flagstaff. Michael Glover, M.D., MBA, is the only surgeon north of Phoenix performing this procedure and is one-of-two surgeons in the state. Dr. Glover is a board-certified, fellowship-trained orthopaedic spine surgeon at NAO and has advanced training in nonsurgical and surgical procedures that help relieve pain and problems of the neck and back.
To learn more about Endoscopic Spine Surgery or other spinal surgery options, contact the Spine and Pain Center for a full consultation. Call 928-226-2900 or click here to request an appointment. The Spine and Pain Center is a service of Northern Arizona Orthopaedics and is located inside the Summit Center.