Minimally Invasive Spinal Surgery is the use of modern techniques to accomplish predictable relief of back or leg pain with the smallest surgical exposure. The overall goal of surgery is the same as traditional open surgery, but with less “down time”.

Microdiskectomy has been the classic example of minimally invasive spinal surgery. Performed through a one-inch incision and using the operating microscope, it involves removing a herniated disk or bone spurs off the sciatic nerve, relieving buttock and leg pain. When it is be done through a tube retractor, it is known as “endoscopic” microdiskectomy.

More complex operations, such as lumbar fusions (for degenerating disks) can be done with MISS as well. The key in fusions is to place as much bone graft as possible in place to “weld” the degenerating spine together. In addition, rigid plates and screws are usually required to ensure proper healing. As surgical exposure is limited, a small second incision is usually required in the abdomen to place a bone graft into the front of the spine.

Other minimally invasive techniques have not proven as valuable. Lasers, needles, and electrothermal cautery have been unimpressive and have been abandoned by most. A similar technique, known as nucleoplasty, has likewise met with less than ideal results. It appears these cauterization techniques cannot repair the damage done by either degeneration or herniation of the disk.