Spine surgery is commonly undertaken for back/leg pain due to mechanical instability of the spine. The Department of Orthopaedic Surgery at Singapore General Hospital explains how minimally invasive spine surgery is carried out and its benefits.
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Back and neck pain, in most cases, can be remedied with non-surgical treatments such as medications and physiotherapy. Chronic back and neck pain that are due to more serious causes such as herniated disc and spinal diseases which can potentially lead to disability, surgical treatment such as minimally invasive spine surgery is an option.
Minimally invasive spine surgery
Spine surgery is commonly undertaken for back and/or leg pain due to:
- ‘Pinched nerves’ in the back (due to either a ‘slipped disc’ or bone spurs)
- Mechanical instability of the spine where one bone of the spine moves abnormally over its neighbour (due to degeneration of the spine and spondylolisthesis)
In the first case, surgery is aimed at decompressing the affected nerves by removing the ‘slipped disc’ or bone spurs. For the latter, surgery is aimed at stabilising the spine by fusing the spine (by applying bone chips between the affected segments and using screws and rods to hold the segments together).
While traditional spine surgery is good at achieving these aims, the recovery process is painful and can be prolonged due to the damage to the muscles and their nerve and blood supply in the process of exposing the spine. A long skin incision is usually required for the exposure and the muscles pulled apart to aid visualisation.
Benefits of minimally invasive spine surgery
Advancements in technologies and techniques allow the same surgeries to be performed via smaller incisions. The same aims can also be achieved just as safely while minimising damage to the muscles. The overall benefits are shorter hospitalisation, as short as one day for decompression surgery and two days for fusion surgery, and quicker return to functions and work.
In this technique, x-rays are used to guide the insertion of tubes to reach the spine and visualisation is achieved with the use of a microscope and special cameras. The nerves are decompressed with specially modified instruments. If necessary, screws and rods are inserted under x-ray guidance.
Who is it suitable for?
Such surgeries may be suitable for patients with low back pain and/or leg pain that interferes with normal activities and work; and for which other treatments such as physiotherapy and medication are not working. The orthopaedic surgeon will have performed a thorough examination of your back and nerves, including x-rays and MRI scans, before deciding on whether such an operation is suitable for you and which surgery is more appropriate for your specific condition.