What are the risks of minimally invasive spinal surgery? When my surgeon talks to me about it, everything sounds so hunkey dorey. What kinds of problems could I potentially run into? I am planning to have a one-level spinal fusion in three weeks.
There is more and more evidence to support minimally invasive procedures. Studies show that patients recover faster with less time in the hospital and fewer costs. They return to daily activities and work sooner, too. In the hands of a skilled surgeon, the procedure is safe and effective with less tissue damage, less blood loss, and less post-operative pain. The use of a tubular retractor with minimally invasive procedures (instead of the self-retaining type of retraction used with open incision surgery) has reduced the incidence of crush injuries to the muscles, blood vessels, and nerves. Loss of blood supply to the muscles and damage to the nerves from the self-retaining retraction often meant the patient never regained the muscle strength needed to support the spine. The result was often chronic back pain and weakness, a condition referred to as failed back surgery syndrome. This set of complications has been diminished greatly with the tubular retraction used with minimally invasive spinal surgery. There are some drawbacks to minimally invasive surgery (MIS) and some potential complications. Surgeons who are not doing MIS say it is because the opportunity to learn this technique is limited. Intra-operative and post-operative problems are much higher when the surgeon is gaining experience. The technical difficulties can be overcome with training and practice but it takes time. The procedure does require the use of fluoroscopy, a type of real-time X-ray. Exposure to radiation from the fluoroscopy is at low levels and fairly limited (one to four minutes). The danger is really more for the surgeon and operating room staff who are exposed with each patient. As with any spinal surgery (whether open or via minimally invasive approaches), there is always a risk of blood clot formation, bone fracture, nerve damage, or screws going in at a wrong angle or backing out after surgery.