Basics of Minimally Invasive Decompression Surgery

Minimally invasive spine surgery has many advantages compared to the traditional open spinal surgery in many ways. There has been many research and studies that have concluded that minimally invasive keyhole spinal surgery results in smaller incisions and scare, have decreased blood loss during surgery, shorter duration of stay in the hospital for patients and less pain after surgery leading to less requirement of pain medication while and after hospitalization.

In traditional surgery, the incision required is longer as the surgeon requires a full visual and physical access to the affected region. As the incision is made, the surrounding structures are retracted or pulled. Structures such as muscles are also pulled to the side to allow a clear view of the spine. The diseased and damaged part of the bone is then removed along with the affected intervertebral discs. The same results can be achieved with the use of minimally invasive keyhole spinal surgery.

Minimally invasive decompression surgery is performed for those with chronic back pain as this condition not only causes pain but may also cause difficulty with movement and stiffness that prevents the activities of daily living.

Minimally invasive decompression surgery is performed for patients who have a compressed nerve in their spinal cord, leading to local pain that may also radiate down the affected limb. Although nerve compression can happen due to multiple causes, it happens most commonly in spinal stenosis (narrowing of the spinal canal that allows the nerve to move out of the spine to the limbs), herniated disc and bulging disc the discs in between the vertebrae bulges out causing compression on the nerves), pinched nerve (nerve can be pinched due to multiple causes), bone spurs (bony overgrowth causing compression on the nerves), sciatica (compression of nerves usually in the lumbar spine causing radiation of pain down the leg), arthritis of the spine (degeneration of the spine causing pinched nerve) and more.

There are many types of minimally invasive keyhole decompression surgeries, all that aim to relief the pressure on the compressed nerve. By relieving the pressure on the affected nerve, the patient often finds pain relief.  The three main types of minimally invasive keyhole decompression procedures involve foraminotomy, laminotomy and discectomy. These three surgeries are used for different causes of a pinched nerve.

In foraminotomy, the narrowing of the foramen (the spinal canal which lets the nerve to move out of the spinal cord) caused by bulging discs, herniated discs, scar tissue or bone spurs can be treated by widening the foramen.  Laminotomy is used to relive pressure on the spinal cord that is caused by stenosis of the spine that can happen due to herniated or bulging discs.

Discectomy aims to relieve part of the intervertebral disc that is pressing on the nerve or spinal cord. Tiny cameras are used to visualize what causes the compression and it is then removed with minimal changes to the spine.