Minimally invasive spinal surgery leads to better patient outcomes

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Dr Jaytesh Pillay, an orthopaedic and spinal surgeon, performed Mediclinic Kloof’s first minimally invasive spinal surgery in March this year. He explains the benefits for patients.

Spinal surgery – facts and fiction

Dr Pillay says he’s proud to have introduced minimally invasive spinal surgery at Mediclinic Kloof. Since the first procedure, he has carried out several more with excellent results. “As the technology evolves, companies have started bringing more advanced equipment into South Africa, which has now allowed us to do these minimally invasive spinal surgeries,” he says.

Dr Pillay is keen to dispel prevailing stigmas and myths about spinal surgery. “You hear people say you’ll never get better, or the pain doesn’t go away, or you’re going to end up in a wheelchair. But the truth is that spinal surgery, if done correctly and for the right reasons, is usually successful.”

He cites medical studies that show certain spinal surgeries offer the best quality of life outcomes when compared to other orthopaedic surgeries. This is especially true when minimally invasive techniques are used. “It is the more progressive way to do spinal surgery,” he says. “In these surgeries, we’re using smaller cuts or incisions, special retractors, and less muscle dissection, all of which cause less trauma to the spine.”

Quicker recovery, better patient outcomes

The fact that minimally invasive spinal surgery results in less spinal trauma means patients recover more swiftly, Dr Pillay explains. “Theatre time is faster, there’s less blood loss during surgery and therefore fewer complications afterwards,” he says.

Most people fully recover in about six weeks, and this recovery time is getting shorter. Many patients are now able to manage well at home and might only need one physiotherapy session after two weeks, instead of home care and several follow-up visits like in the past. However, some patients may still need a longer or more intensive recovery period, depending on their individual situation.

Dr Pillay explains that, just like cell phones are upgraded as technology improves, surgical techniques are also constantly advancing. These improvements are resulting in higher success rates for surgeries. “Remember that minimally invasive surgery involves the same procedure, but with a different, less traumatic approach.”

Mediclinic Kloof’s first minimally invasive spinal surgery

The first procedure at Mediclinic Kloof, performed in March, was on a woman in her 60s. “She had a history of back pain with leg pain, and it got to a point where she couldn't manage her life,” says Dr Pillay. Before considering surgery, she’d been treated with more conservative methods such as physiotherapy, biokinetics and pain injections. The surgery was a last resort.

“The surgery itself was relatively uncomplicated and all went well,” Dr Pillay says. “The patient was walking on the same day. Considering it was a first at Mediclinic Kloof, it was exciting for our theatre staff and nurses, who were eager to see what the surgery was about and were able to perform very competently.”

Dr Pillay and his team have since performed multiple minimally invasive spinal surgeries. He gives his patients the option of surgery the traditional way or the minimally invasive way, explaining the pros and cons of each. “We make a decision together as to which one will have a better outcome for the individual.”

Who qualifies for minimally invasive spinal surgery?

“We always ensure patients have tried all kinds of conservative treatments before doing surgery,” Dr Pillay explains. For now, the minimally invasive spinal surgery approach focuses on lower-back problems in patients of all ages and body types. “There must also be some sort of sciatica (nerve involvement), which leads to pain going down to the leg. We usually do an MRI scan and if we find nerve compression, then we know minimally invasive surgery may work.” Patients who injure their spines in accidents are also good candidates for minimally invasive surgery, he adds.

However, this minimally invasive approach is not suitable for patients with severe nerve compression at several levels or those who have had multiple open spinal surgeries, as their conditions are more complex. 

The future of minimally invasive surgery lies in the use of navigation and robotic surgery, Dr Pillay says. “These will further streamline the surgical process and be of even more benefit to patients.”