- Are You a Candidate for Minimally Invasive Spine Surgery?
- Have you had back and leg pain OR neck and arm pain for the past two months? This could include numbness, tingling, weakness and sharp shooting pain.
- Does an MRI taken within the last six months show a bulging or herniated disc, stenosis, or an annular tear?
- Does the pain start from a recent back or neck injury?
- Does your pain consistently occur in the same place?
- Have you ever been treated for a spine condition?
- Have you tried spinal injections and ablations to relieve pain?
- Have you been prescribed medication to help manage your pain?
- Have you tried physical therapy, chiropractic, or massage for at least two months, but are still in pain?
- Have you tried spinal injections and ablations but still experiencing pain and you are looking for options?
- Have you already been told by a surgeon that you need spine surgery?
Treatment for back or neck pain doesn’t always mean surgery. But if your answer is YES to many of the questions above, YOU MAY BE A CANDIDATE FOR MINIMALLY INVASIVE SPINE SURGERY WITH OUR BOARD-CERTIFIED SPINE SURGEON.
Minimally invasive spine surgery (MIS) was first performed in the 1980s, but has recently seen rapid advances. Technological advances have enabled spine surgeons to expand patient selection and treat an evolving array of spinal disorders, such as degenerative disc disease, herniated disc, fractures, tumors, infections, instability and deformity.
MIS was developed to treat disorders of the spine with less disruption to the muscles. This can result in quick recovery, reduced operative blood loss, and speed patient return to normal function. In some MIS approaches, also called “keyhole surgeries”, surgeons use a tiny endoscope with a magnified high-definition camera on the end, which is inserted through a small incision on the skin. The camera provides surgeons with direct visualization of an inside view, enabling surgical access to the affected area of the spine. These surgeries are called Endoscopic Micro-discectomy, Endoscopic Laminectomy, Endoscopic Foraminotomy, Endoscopic Rhizotomy and Endo-Lif (Endoscopic Lumbar Inter-body Fusion).
Training and experience is critical and of upmost importance when selecting a surgeon. Our Minimally Invasive Spine Medical Director and lead surgeon, Dr. Issada Thongtrangan, is fellowship-trained in both Neurosurgical and Orthopedic Spine Surgery (completed at the World-Renowned Stanford University Medical Center and Texas Back Institute). Dr. T is board-certified and has placed an emphasis on his training and career in Minimally Invasive Spine Surgery Techniques.
Many spine surgeons can perform surgery but patients should be concerned if they offer the latest technology and advanced techniques. Patients should also have a clear understanding of how the surgery will be performed in addition to how ‘large’ the incision will be and if the muscle will be retracted away from the spine to access the surgical area or if they use a technology to minimize the surrounding muscle and soft-tissue damage by utilizing endoscopes and tiny tubes to accomplish the task with the incision of less than one inch.
Minimally invasive spine surgery uses smaller incisions, 1/4 – 1 inch in length. The technique causes very minimal damage to the surrounding soft tissue and muscle by placing working tubes, endoscope and instruments along your natural muscle fiber path. Several studies reported a shorter surgery center stay, lower complication rates and lower infection rates compared with traditional, open spine surgeries. The techniques usually involve light magnification of the surgical site with microscope, microscopic loupes, endoscopes and special instruments that can operate within the small space.
Open spine surgery requires a much more invasive approach where retractors are used, muscle is cut away or retracted to the side away from the spine and the bony structure of the spine are exposed. This method has increased risk of infection, blood loss, recovery time and requires a hospital stay in most cases and in some patients.
Many spinal conditions can be treated by minimally invasive and/or laser spine surgery. Discussing the difference and benefits of each method is an important part of the diagnosis process that our surgeons utilize.
These most common conditions treated include: lumbar and cervical disc herniations, degenerative disc disease, Spinal Stenosis, Sciatica, Spondylolisthesis, spondylosis, facet joint syndrome, spinal fractures and scoliosis.
Many spinal fusions can be done with minimally invasive spine surgery techniques using very small incisions or a percutaneous approach such as “Lateral Lumbar inter-body Fusion, Transforaminal Lumbar inter-body Fusion and the latest technology Endoscopic Lumbar Fusion. Our surgeons have advanced skills in endoscopic lumbar spinal fusions and compliement the surgery with the latest technology for lumbar spinal implants.
The risks of Minimally Invasive Spine Surgery are similar to open traditional surgery. Patients’ outcomes are our main focus. some patients have fear of being paralyzed from spine surgery. At our center, we utilize intra-operative Neuro-Monitoring where electrical leads are placed on a specific area of the body that allows our surgeon to monitor spinal nerves and/or spinal cord during the surgery. The surgeon has a certified tech in the operating room and connects with the neurologist for live feedback of any nerves that may become irritated during the surgery.
As with all non-emergency spinal surgeries, the patient should undergo an appropriate period of conservative treatment, such as activities modification, physical therapy, pain medication, spinal injections or bracing, without showing improvement before surgery is considered. The time period of this varies depending on the specific condition and procedure, but is generally six weeks to six months. The benefits of surgery should always be weighed carefully around its risks. Although a large percentage of patients report significant symptom and pain relief, there is no guarantee that surgery will help every individual.
Yes, most of our Minimally Invasive Spine Surgery procedures can be performed in our out-patient surgery center. Patients are released to return home the same day, experience less post-operative pain, and have a reduced risk of infection. Another advantage of utilizing an out-patient surgery center is that we can control the cost of each patients’ surgery, thus saving them on out-of-pocket costs.
Depending on the level of physical exertion required by the employer, our surgeon will suggest the appropriate time off to recover and heal the most effectively. In our Minimlaly Invasive Endoscopic Spine surgeries, patients are asked to wear a back brace for one to four weeks depending on which procedure was performed. Many of our patients return back to work within a week with some limitations. Our surgeon will answer the estimated time off work needed at the new patient consultation.
We do not allow driving while wearing a brace or after surgery. You are allowed to be a passenger.
Depending on the surgery performed, our surgeon will determine the length of time to allow for healing. Our goal is to get each patient active as soon as possible and continue to strengthen their core to help stabilize the spine.
We see a number of patients who seek a second opinion prior to proceeding with surgery. We feel it is important to fully understand the benefits as well as any risks involved. Bringing a family member to each patient’s consultation is recommended by our team.
We accept most insurance plans, including Private/Commercial insurances, PPOs, Worker’s Comp and Personal Injury Liens. Our office staff will verify this for you at no charge. We specialize in negotiating with insurance companies on behalf of each patient and are very successful in reducing out-of-pocket costs.
We offer free Same Day initial medical consults to patients; we also encourage a Free MRI Review at this time. We are confident that you are in the right place and receive the best care possible and the latest, cutting-edge Minimally Invasive Spine Surgery options are available!
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Pain presents itself in many different ways, at different times and in many cases is triggered by specific activities. We will be happy to answer your questions in conjunction with a personal phone call follow up with one of our doctors.