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A spine fusion is aimed at alleviating pain that is believed to originate from a motion segment in the spine. For some patients, it may be recommended to have a spine fusion surgery performed in both the front and back of the spine in an effort to provide extra stability for the painful motion segment. There is some new evidence about these types of procedures, and the use of a minimally invasive spinal fusion system may sometimes be considered.
At the time of this article, minimally invasive spine fusion technology is still in the early stages of development. This type of procedure uses a needle, which is inserted through small incisions in the back, and radiographic magnified images of the spine are projected onto television screens in the operating room. Narrow surgical instruments are then inserted into the small (1 to 1 ½ cm) incisions to complete the operation.
The goals of minimally invasive spine fusion surgery systems include:
At the time of this article, minimally invasive spinal fusion technology is still new, and none of the above benefits have been definitively proven. Some spine surgeons have anecdotal evidence from their own practice indicating that patients have better outcomes with using a minimally invasive spine surgery system, and other surgeons have anecdotal evidence from their practice that patients have better outcomes with techniques associated with traditional (open) approaches to spine fusion surgery.
Use of a minimally invasive spine fusion surgery system is best suited for patients with degenerative disc disease or spondylolisthesis. The technique does not allow the spine surgeon to do a central decompression. Foraminal decompression can be achieved by interbody distraction and grafting. If there is any central stenosis an open incision still needs to be made. Due to the limited visualization at the time of surgery, it is a difficult and possibly dangerous technique to use in patients with a severe deformity.
Dr. Goldstein also recommends this overview of Minimally Invasive Spine Surgery
About Dr. Goldstein
Minimally Invasive Surgery
Minimally Invasive Fusion
Theory and MISS
Anterior Approach MISS
Anterior Approach Incision
Lumbar Degenerative Disc
Lumbar Disc Herniation
Dr. Goldstein is recognized as one of the leading spine surgeons in New York. He is a Clinical Professore of Orthopedic Surgery and Neurosurgery at the NYU School of Medicine. His expertise is sought by television, media, and magazines. His practice is focused on surgical treatment:
Dr. Goldstein serves as Director of the Spine Service at NYU Langone Medical Center Hospital for Joint Diseases.
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