Minimally Invasive Surgery  
  Minimally Invasive Surgery (MIS) is one of the most significant new advances in treating back pain.

In cases where spine surgery was called for, the traditional approach required large incisions and stripping of the muscles from the bony elements of the spine. During longer procedures, vital nerves and muscles might be denied adequate blood supply.

Typically, the recovery period was long and delayed the patient from experiencing the full benefit of the surgery. In some cases, the loss of muscle mass and back stability from the procedure itself risked a disabling outcome that the surgery itself was intended to cure.

MIS, also called Minimal Access Surgery (MAS), involves performing spine surgeries through small incisions, typically two or more small incisions in place of one large incision. The goal is to limit damage to nerves and muscles while approaching and operating on the spine. By utilizing either an endoscopic camera or magnification (loupes or microscopes) through a small tube to visualize a small portion of the spine, the surgeon utilizing MIS seeks to complete the procedure with the least surgical trauma possible.

The results have been exciting. Medical studies indicate that patients respond with shorter hospital stays, reduced post-operative pain, earlier return to work and improved satisfaction. Long-term benefits are believed to include reduced scarring, improved body mechanics and reduced need for re-operation for spinal instability.

Two issues are currently inhibiting the broad adoption of MIS techniques for spine surgery. The first is simply the challenge of training and education. Performing MIS techniques involves practices that are fundamentally different from traditional practices. For example, the surgeon is required to use either a 2D monitor or a small tube resulting in a change in the visualization of the spine. Different instruments and implants are also required. In order to perform MIS techniques, surgeons must undergo specialized hands-on training.

Providing training to surgeons on MIS techniques is one of the primary goals of the National Spine Foundation.

The other challenge for a broader adoption of MIS is the lack of necessary instruments and implants for some spine surgery procedures. With reduced access, new screws, rods and cages are required. Many simply aren’t available yet for some procedures, requiring surgeons trained in MIS to perform traditional procedures. The National Spine Foundation plans to pursue research on instruments and implants necessary to expand the usage of MIS.
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