The incision for minimally invasive spinal surgery is even smaller than that used in microsurgery at approximately 1 inch across. The tubular retractor that is used to provide access to the spinal column measures around ¾ of an inch across and pushes between the muscles in the back rather than requiring them to be stripped away and held back forcibly. The METRx® system is commonly used by surgeons and can achieve high rates of surgical success. A fiber-optic light and tiny camera are inserted through this created tunnel to give the surgeon excellent visual access to the problematic area of the spine. Tiny instruments such as mini-forceps, curettes, trephines, rasps, burrs, cutters, and probes are then inserted as required to remove the herniated fragment of disc, problematic osteophyte growth, or other material. Nerve root decompression can then occur as the material impinging upon it is extracted using cutting and suction through a discectome (hollow suction tube).
Potential Risks of Surgery
There are potential complications however, with the possibility that the surgeon will have to conduct an open procedure anyway, the risk of neurological damage, and soft tissue trauma. Due to the smaller operating area and the nature of the instrumentation used there is also the added risk of the instrumentation breaking which would extend surgery time or necessitate a transition to an open procedure. Minimally invasive spinal surgery can be conducted as an outpatient in contrast to the lengthy stay in hospital usually required with traditional open back surgery. Success rates are usually around 80-90% for treating sciatica with minimally invasive spinal surgery.
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Microendoscopic Lumbar Discectomy Video from Medtronic (METRx)