If nonsurgical treatments are ineffective in treating your neck or back pain, your doctor may recommend spine surgery. The spine surgeons of Och Spine at NewYork-Presbyterian perform more spine procedures than any other hospital in New York City.*
Whenever appropriate, they use advanced minimally invasive spine surgery techniques, which are more sophisticated and accessible than ever before. These procedures are a viable solution for relieving discomfort in many people with neck, upper back, thoracic spine, or lower back pain.
Our minimally invasive spine surgeons operate through small incisions and use augmented reality technology and computer-guided navigation to precisely complete these procedures. Some patients are able to have outpatient surgery, enabling them to return to the comfort of their homes the same day and avoid an inpatient hospital stay. Find out if minimally invasive spine surgery at Och Spine is an option for you.
*SPARCS data 2019
What is Minimally Invasive Spine Surgery?
With minimally invasive spine surgery, the surgeon operates through small incisions using advanced tools and guided by imaging technologies to see inside the spine. Some of these operations can be completed using an endoscope—a flexible, lighted tube with a camera at its tip that acts as a microscope to get a close-up view inside the spine.
Minimally invasive spine surgery is different than “open” spine surgery, where the surgeon has to make a larger incision to cut into and move aside muscles to access the part of the spine to be treated. Some conditions, such as severe spinal deformities, may require open surgery. But whenever minimally invasive spine surgery is an option for a particular patient, our surgeons use it.
How is Minimally Invasive Spine Surgery Performed?
Your surgical team will include your spine surgeon and any assisting surgeons, nurses, anesthesiologists, and technologists that may be needed to perform certain procedures.
- You will be placed in the position that is best for your procedure, such as lying on your stomach. Some patients having neck surgery lie on their back, and the surgeon enters the spine from the front.
- You will receive medication to be comfortable. Depending on your procedure, this may include a local anesthetic with sedation or a general anesthetic.
- The surgeon will make a few small incisions and insert the instruments needed to create a route to the spine and complete the treatment—guided by an operating microscope, endoscope, images such as X-rays (fluoroscopy), and often computer-generated models that help your surgeon navigate the safest route through your spine. Your surgeon will be able to view the inside of your spine on monitors in the operating room.
- After completing the operation, the incisions are closed with stitches, or if they are very small (such as those following endoscopic surgery), a bandage.
- You may stay in the hospital for 1-3 days or be permitted to go home the same day, depending on your surgery.
- Your care team will give you instructions about caring for yourself as you recover. Some people have physical therapy to support their recovery after spine surgery.
What are the Benefits of Minimally Invasive Spine Surgery?
Compared with open spine surgery, minimally invasive spine surgery offers a shorter recovery time as well as other benefits, including:
- Smaller incisions, which means smaller scars
- A reduced risk of infection and other complications
- Less blood loss during the procedure
- Less cutting of muscles and other soft tissues
- A shorter hospital stay and sometimes the ability to go home the same day
- Less pain after surgery
- A quicker return to your normal activities
What Conditions can be Treated with Minimally Invasive Spine Surgery?
Minimally invasive spine surgery is an option for many patients whose back pain symptoms were not sufficiently relieved using nonsurgical methods, including people with:
Types of Minimally Invasive Spine Surgery Procedures
There is an ever-expanding range of minimally invasive spine surgical procedures, with several options for each type of spine condition. Some of the most common are described here.
Discectomy is the removal of a spinal disc or the bulge of the disc, eliminating its pressure on a nearby nerve root and relieving pain.
- The procedure may be performed as a “microdiscectomy,” operating through a half-inch incision to carefully remove the herniation and free the nerve.
- People with stenosis of the cervical spine (neck) may have anterior cervical discectomy and spinal fusion, where the surgeon operates from the front of the neck guided by a high-powered microscope to remove the affected disc(s) and relieve pressure on the spinal cord. Spinal fusion may then be performed to stabilize the area.
- Some people who have a disc removed also have an artificial disc inserted into the space between the vertebrae.
Minimally invasive spine decompression procedures relieve pressure on the spinal cord or nerves caused by disorders such as spinal tumors or spinal stenosis.
- Bone grafts and metallic implants may be used to restore the spine's stability in patients with fractures and those who need extensive tumor removal.
- Lumbar decompression is one of the most common procedures used to treat spinal stenosis in the lower back. The surgeon removes a part of the bone and excess ligament that is creating pressure.
- During a laminotomy, only part of the lamina is removed (the part of the vertebra that covers the spinal canal, which houses the spinal cord and nerves); the surgeon creates a hole just large enough to relieve the pressure in a specific location.
Endoscopic minimally invasive spine surgery
Och Spine surgeons are among the few trained to perform minimally invasive spine surgery through an endoscope.
- Endoscopic discectomy is an advanced technique performed through an incision less than a quarter-inch across to treat a herniated disc during an outpatient procedure.
- With endoscopic spinal decompression, the surgeon decompresses the nerve by opening the foramen (the passage in a vertebra through which the nerve passes), and many patients go home the same day.
Laminectomy with discectomy
Laminectomy is removal of the part of the bone of a vertebra that is pressing on the spinal cord or a nerve.
- During laminectomy for spinal stenosis, the surgeon enters through the back of the spine and removes the lamina (the section of bone that covers the spinal canal) to relieve the pressure. This surgery is typically performed with a discectomy.
- If a single nerve is compressed in the cervical spine, minimally invasive “foraminotomy” can be performed through a small tube the size of a dime. Part of the bone is drilled off to create more room for the nerve. Sometimes if a herniated disc is present, it can be removed at the same time.
Lumbar spinal fusion
If other surgical techniques are ineffective in treating spinal stenosis, fusing two vertebrae so there is no longer any motion between them may be an option. This reduces spinal pressure, pain, and nerve damage. Our surgeons often use minimally invasive techniques to unite the two vertebrae while avoiding injury to nearby delicate nerve tissue.
Vertebral compression fracture repair
Vertebroplasty and kyphoplasty are treatments for compression fractures of the vertebrae caused by osteoporosis. Both procedures are performed under X-ray guidance.
- During vertebroplasty, the surgeon injects artificial bone cement into a vertebra that has been fractured by osteoporosis. The cement stabilizes the bone and prevents further damage from occurring.
- With balloon kyphoplasty, a tiny balloon is first inflated inside the fractured vertebra to restore its height. The cement is then injected into the expanded space to ensure the bone does not collapse again.
Am I a Good Candidate for Minimally Invasive Spine Surgery?
Many people with lingering pain in the neck and back are candidates for minimally invasive spine surgery, but only a visit with a spine specialist will let you know for sure. There are risks associated with every type of surgery. Speak with one of our spine specialists about your options to learn what treatment may be best for you.
Receive Personalized Spine Care at Och Spine at NewYork-Presbyterian
Many spine surgeries today can be completed using minimally invasive approaches associated with smaller incisions and a faster recovery time. If you need spine surgery, the experts of Och Spine can thoroughly evaluate you and let you know if you are a candidate for one of these innovative treatments. Call today to make an appointment.