My surgeon told me straight out she is learning a new technique for spinal fusion called minimally invasive. Though she has practiced on many cadavers and been supervised by more experienced surgeons indozens of surgeries, I'll still be only the 14th patient she's actually used this method on solo. Do you think it's still safe?
As the technique for lumbar fusion has changed and progressed, so have the surgical instruments used in fusions. It is now possible to use small incisions yet still get the full view of the spine being operated on. That's what we mean by minimally invasive surgery. Special tubular retractor systems hold the skin and soft tissues open over the segment being fused. Real-time (3-D) X-rays called fluoroscopy make it possible to see inside the spine and aid in the procedure.
The minimally invasive approach has been shown to reduce blood loss, speed up recovery, and shave off the number of days patients spend in the hospital. But there's a steep learning curve for the surgeon. It takes a while before the procedure has been done enough times to gain the expertise and accuracy needed for the best possible outcomes. That's probably the biggest drawback to minimally invasive interbody fusion.
But the new technology provides the surgeon with better lighting and magnification of the surgical site. For example, it is possible to see the entire spinal joint now with the tube that forms a working channel for the surgeon to pass surgical instruments. That's important in this particular procedure as the surgeon is cleaning out the opening around the spinal nerve root next to the joint and possibly even removing some of the bone that helps form the joint.
All indications from studies done so far that the procedure is safe and just as effective as the open surgery. What remains to be explored are the long-term effects and differences between these two surgical techniques. Larger studies comparing equal groups of patients are also needed to generate statistical validity for results.
This type of information will help surgeons choose patients more carefully for minimally invasive lumbar spinal fusions in order to get the best outcomes.