MiniMally invasive, endoscopic,
and laser Spine Surgery
by Paul R. Jeffords, MD
The trend in spine surgery has moved toward minimally invasive procedures.
Minimally invasive spine surgery involves surgical treatment of the spine
through small incisions with minimal disruption of the surrounding muscle
tissue. The benefits of minimally invasive spine surgery include decreased
pain, shorter hospital stays and quicker recovery.
Open Surgery and fying telescopic eyeglasses called is a series of gradually expand-
loupes or a magnifying microscope. ing tubes that gently and progres-
Minimally Invasive Surgery Traditionally, open procedures have sively dilate and separate muscles
Surgical procedures of the spine
required larger incisions and more and soft tissues to expose the
are often referred to as an “open”
muscle tissue distraction than mini- operative field. Using specialized
procedure or minimally invasive. An
mally invasive surgery. instruments, surgery is performed
open procedure involves making a
through the tube.
skin incision and retracting (mov-
Minimally invasive surgical tech-
ing aside) any tissues overlying
the anatomy that is to be worked
niques utilize specialized retractors, Laser Spine Surgery
which allow a surgical procedure to Lasers are one of many specialized
on so that the surgeon can direct-
be done through smaller incisions tools that can be used during mini-
ly view the desired anatomy. The
with much less tissue disruption. mally invasive spine surgery. There
surgeon will view the anatomy
One of these specialized retractors is a common misconception that
either with the naked eye, magni-
is called a tubular retractor, which if a laser is used during surgery,
16 Back Talk
no incisions need to be made. The patient remains awake during In summary, minimally invasive spi-
Unfortunately, this is not the case. the procedure. The surgery is nal surgery is not for everyone.
A laser is like any other surgical performed using a local anesthetic. To determine if you are a candi-
tool. In order for it to be used, it Using X-ray guidance and date, schedule an evaluation by
has to be placed into the appro- endoscopic visualization, micro- a surgeon knowledgeable and
priate area of the body through instruments are used to remove the experienced in these special
an incision. damaged disc. A laser may or may surgical techniques.
A second misconception is that
lasers can be used to remove arthri-
tis. Spinal arthritis is a condition in
which the facet joints degen-
erate and become inflamed.
Unfortunately, there is no cure
for arthritis, and it cannot be
Finally, many are under the
impression that laser surgery is
always better than traditional sur-
gery. Although the laser is used
for certain procedures, not all spinal
conditions can be safely or appropri-
ately treated with a laser. So using
a laser does not always provide
advantages over other techniques.
Spine Surgery Transforaminal Endoscopic Discectomy
An endoscope is a very thin fiber-
optic video camera that can be
used to visualize internal por- not be used during this procedure.
tions of the body. The endoscope On average, the procedure takes
camera is made with built-in about 30 minutes to one hour
magnification and a light source. per disc. Upon completion of the
Images are relayed to a monitor procedure, the incision is covered
similar to a television. with a small bandaid.
Transforaminal Endoscopic Summary
Discectomy is a technique that Minimally invasive surgery is Paul R. Jeffords, MD, received his
is being performed at Resurgens emerging as an alternative, reliable medical degree from Tulane University
Spine Center to treat herniated discs method of treatment for a variety School of Medicine in New Orleans.
in the lumbar spine. Transforaminal of spinal disorders. Like “building He completed his residency at Emory
literally means “through the a ship in a bottle,” there is a steep University in Atlanta, Georgia, his fel-
foramen.” The foramen is the learning curve for surgeons learning lowship at the Texas Back Institute in
“window” or “tunnel” through to do these procedures. Although Plano, Texas. Dr. Jeffords is Board
which the nerve exits from the the recovery is often faster, the Certified by the American Board of
spinal canal at each disc level. The complication rates can be greater Orthopaedic Surgeons and a member of
foramen are located on the sides and the results not as predictable. the American Academy of Orthopaedic
of the spinal canal and provide Minimally invasive surgery is Surgeons, North American Spine
a natural window through which certainly the wave of the future Society, Georgia Orthopaedic Society
the spinal canal can be accessed and will continue to develop as and Atlanta Orthopaedic Society.
without having to remove any bone newer, safer techniques continue
or ligament tissue. to evolve.
Resurgens Spine Center 17