Minimally invasive spine surgery refers to a series of minimally invasive techniques applied to spine surgery to treat spinal injuries and diseases. After more than 20 years of accumulation, from tracking to innovation, our center now has a complete set of cutting-edge equipment, including spinal endoscopy, surgical microscope, minimally invasive channel retraction system, microscopic grinding drill, surgical navigation system, integrated digital operating room, surgical robot (on order), etc. The team is capable of performing a full range of minimally invasive spine surgery, including the latest international technology, from spinal endoscopy to minimally invasive fusion and fixation, from common disc herniation to complex scoliosis deformity and spinal tumor, from cervical and thoracic spine to lumbar and sacral spine, and all spinal conditions can be treated with minimally invasive spine surgery. The annual volume of minimally invasive spine surgery is more than 1000 cases.
Introduction to minimally invasive spine surgery
The most important feature of minimally invasive spine surgery is that the surgery is precise, clear and accurate, and only the diseased tissues are addressed, while there is minimal damage to normal tissues, little bleeding, quick recovery, and good functional preservation. However, minimally invasive spine surgery also has certain limitations. At present, minimally invasive techniques cannot be used in all cases that are too complex; as with any technology, a single minimally invasive technique cannot solve all problems, and minimally invasive techniques are a part of a ladder treatment. Different minimally invasive techniques are suitable for different degrees of disease treatment and can be applied in combination in stages.
Common minimally invasive spine procedures.
Interventional block therapy
1, including lumbar and cervical nerve root block closure as well as intervertebral discography, small joint arthrography, and lumbar spinal canalography. Under local anesthesia, the puncture operation is completed under X-ray or CT guidance, and the contrast agent is injected, which can be used to clarify the specific site and source of lumbar and cervical pain; at the same time, slow-release anesthetics and hormones are injected locally to reduce pain, and the effect can be maintained for 1 to several months, which has both diagnostic and therapeutic functions.
Advantages: less damage, lower cost.
Disadvantages: pain relief is mostly temporary, with a maintenance time of about 1-2 months.
2.Disc ablation, including radiofrequency, plasma, laser, ozone, etc. Under local anesthesia, a guide wire is inserted into the intervertebral disc under X-ray or CT guidance to perform ablation, which reduces the pressure of the intervertebral disc and destroys the peripheral nerves causing pain.
Advantages: pain relief is maintained for about six months-2 years.
Disadvantages: Only for inclusive, early lesions of milder disc herniation.
Spinal endoscopy
Spinal endoscopy is a mature technology developed in recent years, mainly for the treatment of lumbar disc herniation and lumbar spinal stenosis, but also gradually for the treatment of cervical disc herniation, and even for the clearance of spinal tuberculosis and intervertebral infection. The damage is very small, with an incision of 6-8 mm; the microscopic image is magnified 10-12 times, and the various tissues can be distinguished very clearly; the treatment is precisely targeted, and the special microscopic tool removes the herniated disc tissue and the hyperplastic bone flab that compress the nerve roots, and the pain relief is very effective; there is almost no need to touch the normal bone structure, and thus there is usually no need to implant internal fixation such as screws; the surgery is performed under local or general anesthesia, and the patient can go down to the floor on the same day. It can be used to treat most lumbar disc herniations, lumbar spinal stenosis, and cervical disc herniations, etc. Different puncture approaches can be used depending on the condition.
Advantages: precise treatment, immediate relief of nerve root pain, very little damage, easy to revise the surgery again.
Disadvantages: It is not possible to solve some specific disc herniation and has a certain recurrence rate.
Minimally invasive spinal fixation and fusion
Traditional open surgery for spinal fixation and fusion can also be done with minimally invasive techniques. The lesion is reached through a special channel of 16-28 mm in diameter, without stripping the muscles, with minimal damage, less bleeding, faster postoperative recovery, and less functional impact. The surgical operations such as nerve decompression, bone grafting, and percutaneous screw fixation can be performed within a small channel with special surgical tools. This minimally invasive technique can perform most of the current routine spine surgeries for lumbar disc herniation, lumbar spinal stenosis, lumbar spine slippage, scoliosis, thoracolumbar fracture, tumor, cervical disc herniation, cervical fracture dislocation, etc.
Advantages: wide indications, less muscle damage, less bleeding, fast postoperative recovery, and less functional impact.
Disadvantages: longer operation time, high technical requirements, high equipment requirements, and higher costs.
Vertebroplasty
It can be used to treat osteoporotic fractures, vertebral hemangiomas, certain vertebral metastatic tumors, etc. Bone cement is injected into the vertebral body through X-ray or CT guidance to fill in the fractured vertebral body, restore the height of the vertebral body, improve the strength of the vertebral body, and also have a pain-relieving effect. It is usually done under local anesthesia and can be used for the following activities on the same day.
Advantages: It can be used for elderly patients with poor physical condition and can get up and move early.
Disadvantages: long-term results are uncertain, and re-fracture of the operated vertebra or adjacent vertebrae is likely to occur.
Note that these techniques are often used in accordance with the principle of step therapy for the treatment of different degrees of disorders ranging from mild to severe and simple to complex.
Frequently Asked Questions.
Q1: Is minimally invasive surgery without an incision?
A: There are many different types of minimally invasive techniques, but they all involve puncturing or cutting into the human body, and they are all invasive surgical operations in a broad sense, except that there are major and minor operations.
Q2: Are there no staples in minimally invasive surgery?
A: Not all minimally invasive procedures do not require internal fixation. Depending on the condition, interventional and endoscopic procedures generally do not use internal fixation, but minimally invasive fusions, for example, require implant fusion and screw fixation, although the nail used can be a percutaneous screw, which is less damaging than a normal screw. The benefits of minimally invasive fixed fusion over interventional and endoscopic procedures are that more complex cases can be handled, the procedure is thorough, and the recurrence rate is lower.
Q3: Is minimally invasive surgery cheap?
A: Because minimally invasive surgery requires the use of new techniques and equipment, minimally invasive surgery is more expensive than conventional surgery of the same level.
Q4: Does minimally invasive surgery mean small incision?
A: In addition to the small incision, minimally invasive surgery also causes minimal damage to the muscles and normal bone tissue, resulting in less bleeding and faster recovery. Moreover, many of these surgeries are performed under local anesthesia and can be tolerated by elderly patients with multiple medical conditions.
Q5:Can all diseases be treated by minimally invasive surgery?
A: Minimally invasive surgery consists of a series of techniques for different diseases, or different degrees of severity of the same disease, called “ladder treatment”. Some are terminal treatments, which basically solve the problem in one operation; some are phased treatments, which mainly aim to reduce the symptoms because there is little damage to normal tissues and it is easy to operate again in case of recurrence; multiple minimally invasive techniques can be applied in a combination of phases.
Q6: Is minimally invasive surgery safe?
A: No matter traditional open surgery or minimally invasive surgery, the principles are the same: firstly, it should be safe and not cause additional harm to the patient; secondly, it should be effective and can really relieve the pain of the disease. Minimally invasive surgery goes further in the pursuit of less damage and faster recovery while meeting the 2 prerequisites of safety and effectiveness.