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Minimally Invasive Spine Surgery Opens Up Options

Things are changing in the operating room when it comes to spine surgeries. The new minimally invasive surgery (MIS) makes it possible to avoid opening up the spine. A small incision is used instead. The surgeon uses new (smaller) tools and special imaging to see inside the spine.

Spinal fusion can be done from the front or the back of the body. In either operation, pedicle screws are inserted into the bone from the back. The screws help hold the spine together until the fusion is complete. But there are problems using the pedicle screws. Can these problems be solved by using MIS to insert the pedicle screws?

In this study, doctors compared two groups of spinal fusion patients to answer this and other questions. One group had the standard open pedicle screw fixation. The second group had a MIS called percutaneous pedicle fixation (PPF). Percutaneous means "through the skin."

To compare results two measures were used: size and strength of the multifidus muscle. The multifidus is a deep spinal muscle that attaches to the vertebrae. With the PPF operation, the multifidus doesn't have to be cut and stripped away from the bone. As shown in this study, there is less bleeding and less damage to the muscle.

There wasn't much difference in pain levels between the two methods of screw insertion. The PPF group used fewer drugs for pain relief. In addition to these benefits, the authors also report shorter operation time with PPF.

References: Dong-Yun Kim, MD, et al. Comparison of Multifidus Muscle Atrophy and Trunk Extension Muscle Strength. In Spine. January 1, 2005. Vol. 30. No. 1. Pp. 123-129.

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