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I have a large herniated disc that hasn't gotten better with conservative care. It looks like surgery is the next step. I'm just starting to check it out. I've heard the new minimally invasive spine surgeries are really the way to go. Is it worth traveling somewhere to get this?

The jury is not in on this topic yet. There haven't been enough studies directly comparing open surgery to the minimally invasive (MI) method. It makes sense that the MI operation would have less blood loss and less soft tissue trauma. But there haven't been any reports to suggest a lower rate of wound healing or infection with the less invasive technique.

And the final outcome (rate of fusion) hasn't been any different between the two methods. The surgery takes longer using the MI method. For men, there's the added risk of problems with sexual function that can occur when the operation is done from the front of the body (anterior approach).

Surgeons are studying patients now to find out who would be the best candidate for this procedure. Sometimes patient selection is an important part of the process. For surgeons just learning the method, the ideal patient may be someone with moderate degenerative disease. This patient should be thin and only need one-level fused.

For now, a review of the studies done so far doesn't seem to indicate the minimally invasive surgery has better results than the standard surgery. Talk to your surgeon about your interest in this new approach. He or she will be able to answer any other more specific questions you may have.

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