Explaining Keyhole or Minimally Invasive Spinal Surgery

Keyhole or minimally invasive spinal surgery (MISS) offers a less traumatic alternative of performing a range of back operations.

Dr Petrus Stone, a neurosurgeon at Mediclinic Bloemfontein, explains the procedure.

How are MISS procedures different from conventional ‘open’ back surgery?

Instead of making incisions in the back of 15-20cm long, neurosurgeons are able to use much smaller incisions as short as 0,5-1cm, or two incisions of 3-5cm each, depending on the procedure required, says Dr Stone. This is made possible by imaging technology that projects the live images onto a screen to guide the surgeons during the operation. The shorter incisions make the procedure less invasive, and hold several advantages for the patient, he explains. ‘Less damage to the skin, ligaments, muscles, blood vessels and nerves of the back mean reduced pain, blood loss and risk of infection, and patients are able to recover faster. Theoretically it’s also economical, because they’re able to go home sooner and there are fewer costly complications.’

How soon could a patient return to work after having such a back operation?

It depends what the particular procedure and on the nature and the level of the patient’s activity in their job, says Dr Stone. Someone who doesn’t sit down all day or do physically demanding work could be back in the saddle as soon as 10 days after the operation, but he generally recommends a recovery period of two to three months for patients who do admin work, and up to six months for people who would be required to do a lot of bending and heavy lifting.

My father is scheduled to have an MISS procedure to free a pinched nerve. He isn’t sure what to expect afterwards. How can I help him prepare for the transition after the procedure?

Dr Stone says it’s a good idea to make arrangements for some physical and emotional support during the first two weeks after the operation – having someone around to assist with domestic duties, grooming and dressing would make things a lot easier. If your father is elderly or frail, a brief period in a step-down (post-operative care) facility afterwards is recommended.

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