Many of the 56 million Americans who experience back pain will not require surgery to address their condition and relieve pain. Non-invasive treatments, such as physical therapy, medication, or injections, can address their symptoms. However, for those who continue to experience pain that interferes with their daily life, advances in surgery are leading to more options, better outcomes and faster recovery.
One of these advances is minimally invasive spine surgery with tubular retractors.
Available at Emory Healthcare, minimally invasive spine surgery with tubular retractors is considered to be the future of spine surgery. Steven M. Presciutti, MD, an orthopaedic surgeon at Emory Orthopaedics & Spine Center in Brookhaven, says, “Minimally invasive spine surgery most often will provide the same results as a traditional surgery, but it offers quicker and easier recovery times compared to a traditional open surgery.”
Tubular retractors allow the surgeon to access the spine while sparing surrounding tissues, tendons, ligaments and muscles that would otherwise be disrupted with traditional surgery. This type of minimally invasive approach, therefore, maintains spinal stability after surgery, and in some certain circumstances, can also save a patient from needing a fusion in the first place.
Dr. Presciutti received special training in MISS during a spine surgery fellowship at Rush University Medical Center. He is one of the few spinal surgeons in the state that offers minimally invasive surgery with tubular retractors as an alternative to traditional, open spinal surgery.
Practicing for about five years at Emory Healthcare, Dr. Presciutti is eager to share his expertise and training with patients at the Emory Spine Center. He shares his insight about minimally invasive spine surgery, including who can benefit from the approach.
What is Minimally Invasive Spine Surgery?
Minimally invasive spine surgery (MISS) with tubular retractors is an alternative to traditional, open spinal surgery.
During a MISS procedure, your surgeon will make a small incision along your spine that measures about two centimeters (about the size of a penny). Then, the tubular retractors will be inserted through the incision and placed down to the spine.
After confirming the correct location, the initial tube is slowly dilatated to provide a small working window down to the spine. The surgeon then passes very small surgical tools through the tube and uses a microscope to maneuver surgical equipment to effectively and accurately treat the spinal condition.
What are the Benefits of Minimally Invasive Spine Surgery?
The main benefits of minimally invasive spine surgery include reduced tissue and muscle damage as well as less blood loss. Traditionally, open spine surgery requires a surgeon to make a much larger incision and often cut through or disrupt muscle, soft tissue and ligaments. This can lead to more pain, a longer recovery time, and even worsening spinal instability later.
Additional benefits of minimally invasive spine surgery include:
- Reduced risk of infection
- Less post-operative pain
- Less rehabilitation requirements
- Faster recovery
- Reduced reliance on pain medication
- Significantly shorter hospital stay
- Shorter length of surgery
What Conditions Can Minimally Invasive Spine Surgery Treat?
Minimally invasive spine surgery with tubular retractors can treat many common back conditions, including:
- Herniated disc (cervical and lumbar)
- Spinal stenosis
- Pain radiating down arm or leg
- Instability of the spine that requires fusion
MISS is not for everyone, however. Your surgeon will discuss if MISS with tubular retractors is right for you and which procedure is appropriate. Spinal surgery available using a minimally invasive tubular retractor include:
- Lumbar laminectomy – A laminectomy is a decompression surgery that removes the lamina, which is the back part of a vertebra that covers the spinal canal. This helps relieve pressure on the spinal nerves. As a minimally invasive surgery, it can be done on the lower back.
- Lumbar microdiscectomy – A microdiscectomy removes a small part of a herniated disc or other material that is pressing on nerves along the spinal column and causing leg pain.
- Transforaminal lumbar interbody fusion (TLIF) – TLIF helps treat spinal instability by fusing the vertebra of the lumbar spine together. This helps relieve pressure from nearby spinal nerves, which can lead to pain and limited range of motion.
- Cervical foraminotomy – This minimally invasive surgery can relieve arm pain from a pinched cervical nerve. It creates more space along the spinal canal to allow nerves to pass through.
Emory Spine Center
The Emory Spine Center provides advanced care for back pain caused by many issues – from muscle injuries to tumors. Our experienced spine physicians work together to diagnose and treat neck and low back problems.
The spine care team at Emory Spine Center includes physiatrists (physicians who specialize in physical medicine and rehabilitation), spine surgeons, physical therapists, and more. We offer a wide range of treatments and services, from diagnostic tools to non-invasive treatments, and, when needed, the latest innovations in spine surgery. The Emory Spine Center is now offering telehealth along with in-person appointments. To schedule your appointment, call 404-778-3350, or visit emoryhealthcare.org/ortho.
About Dr. Presciutti
Steven M. Presciutti, MD, is a spine surgeon at Emory Orthopaedics & Spine Center in Brookhaven. He has received a Career Development Award from the U.S. Department of Veterans Affairs as well as grants from Emory University and the Cervical Spine Research Society. Dr. Presciutti has published numerous studies in peer-reviewed journals and has presented at multiple national and international conferences.