Nobody relishes the idea of having spine surgery. It sounds inherently intrusive. As spine surgeons, it is not a stretch for us to imagine that patients would rather receive less invasive than more invasive procedures.

Minimally invasive spine surgery (MIS) has become a trend in the United States. Most spine surgeons advertise it as part of their practice. We are no exceptions. However, it is not the best choice for patients in all situations.

Should patients seek out minimally invasive surgery?

First, it is important to note that the vast majority of spinal disorders do not require surgery. It is not uncommon for us at Austin Spine to go a full week without seeing a patient who needs surgery.

For conditions that would benefit from surgery, many require a more traditional, “open” operation. Some operations simply lack a minimally invasive option, such as tumor removal, many trauma procedures, and many scoliosis operations.

Not all minimally invasive procedures are as effective or safe as the traditional open operation. In fact, no minimally invasive spine procedure has yet proven superior to an open procedure in a clinical study with long-term follow up.

What are the benefits and drawbacks of minimally invasive spine surgery?

Proponents of minimally invasive spine surgery rightly state that many MIS procedures have shown:

  • Less blood loss during surgery
  • Shorter hospital stays
  • Less need for pain medication after surgery

It may very well show clinical superiority once longer-term comparison trials are completed.

As surgeons who perform a number of minimally invasive operations, we can attest that there does tend to be less blood loss and tissue destruction (a.k.a. collateral damage to the back muscle) with MIS procedures. The hope among MIS advocates is that less muscle disruption will lead to better outcomes and less need for re-operation.

With that said, the spine surgery community has seen several MIS devices that either failed to work as advertised, suffered from high complication rates, or led to surgical outcomes inferior to traditional open approaches. While our group remains open to new ideas, we believe a healthy dose of skepticism is warranted. We tend to let others do the early experimentation with unproven technologies, with eyes towards adopting those that pan out over time. We want to offer our patients procedures that have a proven track record.

Why the surgeon’s experience matters

Unfortunately, just as not all MIS procedures are as good as the traditional operations, not all MIS surgeons are created equal. There are plenty of surgeons with the training, skill set, and patience to perform excellent minimally invasive operations.

However, our group has had patients referred to us who were suffering from a failed MIS operation. In some of these cases, at least part of the problem was that the original surgeon lacked the diligence and meticulous attention to detail needed to successfully complete the procedure.

This is why it is important to choose a spine surgeon who has extensive experience in the procedure you need, whether it is minimally invasive or not. A skilled surgeon will be able to advise the pathway that is best for you, and whether or not minimally invasive procedures are appropriate to achieve the best outcomes.

Will minimally invasive surgery become the standard?

If the current pattern in the medical community continues, there will be a gradual adoption of MIS techniques across the spine surgical landscape. Just as nearly all gallbladders are removed laparoscopically and all ACLs are reconstructed with arthroscopic assistance, it is likely that MIS techniques will become more common in spine surgery. However, training and research must first catch up with the technology.

At Austin Spine, we believe that it is important to use proven surgical techniques for our patients. While we do use MIS techniques when appropriate, we will not recommend them for a procedure unless it has been proven to be effective and provides results greater than or equal to traditional open techniques, as patient outcomes are our top priority.

Minimally Invasive Spine Surgery in Austin, TX

If you would like more information about minimally invasive spine surgery and other spine surgical options at Austin Spine, or would like to schedule an appointment with one of our skilled surgeons, please call our office at (512) 347-7463.