Minimally Invasive Lumbar Spinal Fusion (cont.)
What is minimally invasive lumbar spinal fusion?
Minimally invasive lumbar spinal fusion is similar to traditional lumbar
spinal fusion, but it uses smaller incisions and causes less damage to the
surrounding tissues during surgery.
As with traditional lumbar spinal fusion, there are many specific techniques
available to try to fuse the vertebrae together using minimally invasive
techniques. This can be done through the abdomen, from the back, from the side,
or with any combination of these.
Minimally invasive lumbar fusion through the abdomen uses four small
incisions, approximately ½ inch in length. A fiber optic viewing camera is used,
similar to other minimally invasive procedures including laparoscopic
gallbladder or appendix removal.
Fusion with screws and rods can be performed through the back using several
1-2 inch incisions. In these cases a series of increasingly larger dilators are
inserted through the incisions to help spread the muscles apart. Once the
muscles have been moved away, the screws and rods can be placed through the
dilator tubes. In some cases an operating microscope is used to help the surgeon
see more clearly.
One of the most recent advances in minimally invasive lumbar spinal fusion is
the ability to perform fusion surgery through the patient's side. There are
several techniques that allow the surgeon to make a small incision,
approximately 2 inches in the patient's side, directly over the planned fusion
site. The muscles are then carefully moved aside, and a series of increasing
larger dilators are inserted down to the lumbar spine. Specialized instruments
can then be used through the dilator tube to remove the intervertebral disc and
place a bone graft or metal or plastic spacer in its place. This technique is
typically combined with a procedure from the back to place rods and screws for
additional support.
What are the advantages of minimally invasive lumbar spinal fusion?
The major advantage of all of these minimally invasive techniques is that
there is less damage caused to the surrounding tissues. Unfortunately, in
traditional spinal surgery it is necessary to cut through muscles and move them
out of the way in order to reach the spine. This can cause a large amount of
pain following surgery, and it can lengthen the recovery time. Instead of
cutting and moving muscles, the minimally invasive techniques can more gently
spread through the muscles to allow access to the spine. This is much less
painful for the patient, and it does not require as long of a recovery period
for the muscle to heal.
Another benefit of less muscle damage is less blood loss and thus a reduced
need for blood transfusions using the minimally invasive techniques. There is
often less need for narcotic pain medications following this form of surgery,
and a shorter hospital stay.
Next: What is the disadvantage of minimally invasive lumbar spinal fusion? »
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