What are the Latest Advances in Minimally Invasive Spine Surgery? What to Ask for, What to Avoid
Given the numerous benefits of minimally invasive spinal surgery detailed above, surgeons, doctors, and medical professionals are currently developing new and cutting-edge ways to improve the procedure and provide patients with a range of options that best suit their particular medical situation.
We have already mentioned endoscopic spine surgery and robotic guidance as two techniques that apply the MISS philosophy. Along with those patients also have the option to explore procedures that use:
New robotic tools are being developed to assist doctors in the previously mentioned robotics-guided surgeries. At certain specialty spine hospitals around the United States, surgeons have access to robotics-controlled microscopes that can be used to help surgeons execute each step of a spinal procedure with greater precision, including screw placement and discectomies (removal of degenerated native discs). These microscopes feature superior image resolution and allow for more angled views of the spine.
One of the most exciting trends for spinal surgery as a whole, including MISS, is the use of something similar to what many people have for entertainment in their homes: virtual reality. In contrast to robotics-assisted procedures, or traditional non-MISS procedures where a doctor has to expose more of a patient’s spine, an “augmented reality” approach requires the surgeon to wear a headset that gives them real-time images of the patient’s spine. Combined with MISS techniques such as smaller and fewer incisions, this virtual reality approach facilitates a patient experience that involves fewer surgical intrusions.
Due to effective marketing and snazzy scientific language, certain spinal procedures claiming to use the MISS ethos have gained attention nationally. However, not every procedure with the MISS name attached to it actually lives up to the goals of surgeons that specialize in MISS. Two prominent examples include:
For much of the 2010s, there was extensive marketing about the use of lasers in spinal surgery. Several “laser spine centers” even cropped up throughout the United States as the notion of laser-centric spine surgery gained traction. However, these efforts would ultimately be short-lived. Apart from legal controversies that mired the Laser Spine Institute of Tampa, Florida – including a lawsuit directed at the company by former wrestler Hulk Hogan following what he deemed ineffective procedures – the goals of these laser spine centers run against the grain of what surgeons already know about the use of lasers for spinal operations.
Because of the intense, focused energy of lasers, it is generally advised that they not be used on the spine. The spine protects valuable neurological structures that are less strong than the individual vertebrae of the spine, so it is not worth the risk of using something as powerful as a laser when numerous other MISS alternatives exist. Lasers have been used in some narrow applications for spinal issues, but in the vast majority of cases they would not be a leading option, if an option at all.
Ultrasonic Spine Surgery
Like lasers, ultrasonic surgical tools already exist and are used by hospitals around the United States. Some have suggested that these could be applied to spinal procedures. For the time being, there is no substantial body of evidence to suggest that these sonic tools offer patients any more efficacy than other existing MISS options.
Both of the procedures above, it should also be noted, are not inherently minimally invasive in their application, meaning that ultrasonic and laser-based procedures exist that do not conform to the methods of MISS. In general, be wary of anyone who tries to hook you on a surgical option whose primary appeal is its scientific novelty, or the flashiness of its accompanying technology. A true MISS practitioner’s primary aim should be, above all else, to perform the necessary surgery with a few incisions and interventions as possible, not just to use the flashiest tech.