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Minimally Invasive Endoscopic Spine Procedure in order to reduce chance of Open Spine Surgery

Updated: Aug 23, 2022

According to statistics, 1.62 million spinal surgeries are conducted in the United States every year. Minimizing tissue injury, trauma, and post-operative discomfort is critical to maximizing patient's recovery following surgery. Significant advancements in technology, modalities, and techniques over the years demonstrate how far we've progressed in the surgical options for patients.

News that you require spinal surgery may be a terrifying experience. There are so many complications linked with spinal surgery that it's essential to know what is involved and what will be done. Most surgeons nowadays strive to handle your procedure utilizing minimally invasive techniques, commonly called "MISS" (minimally invasive spinal surgery). With open surgery, you'll have a more extended cut. Skin and muscular tissue around the operation site will be stripped away to provide the surgeon access and enable them to conduct the procedure. Open spine surgery should be reserved as a last option after all conservative and interventional procedures have been exhausted. Endoscopic spine surgery has many advantages over open spine surgery.

Minimally invasive endoscopic spine surgery vs. open surgery

Endoscopic spine surgery is a minimally invasive surgical treatment for spine problems including back and leg pain. A high-definition video camera is connected to an endoscope tube and is inserted via one fourth-inch incision on the skin. The surgeon can use an HD display to view the spine and work with highly specialized devices such as a LASER, RF (radio frequency) probe, or graspers using the endoscope.

Many people are curious to know about open spine surgery. The traditional open spine surgery method is a technique used by old-school neurosurgeons. Your surgeon will make a wide incision in your back during open spine surgery. The next step includes separating your spinal muscles from your bones by dissecting them. They'll utilize equipment to visualize the surgery site and cut off any tissue that is pressing on your spine nerves. They remove the surgical equipment and suture or staple your wound once the procedure is over.

The benefit of MISS over open spine surgery

  • Less chance of injury: The possibility of muscle injury is relatively high with open surgery, but the likelihood of muscle damage is considerably decreased with endoscopic spine surgery, which is a significant advantage.

  • Less Post-operative pain: In endoscopic spine surgery, the discomfort experienced following surgery is minimal. As you can expect, following open surgery, you're dealing with not just the pain from the procedure but also the discomfort created by a lengthy incision, and violation to the bone, muscle and soft tissue. With endoscopic spine surgery, you'll only have one or two minor incisions to deal with, which can help you heal much faster.

  • Less hospitalization: Endoscopic spine surgery is usually performed in an outpatient setting. Patients spend less time in the hospital/surgical center and go home the same day. Quick return home to your comfort zone may significantly accelerate recovery. However, in the case of open spine surgery, a lengthy hospital stay may be required.

  • Fewer narcotic medicine: Fewer narcotics are required in MISS than open spine surgery

  • Quick return to work: Patients who have minimally invasive spine surgery quickly return to work because of faster recovery and fewer complications. Open spine surgery requires rest for months or even a year for complete healing.

  • Quick recovery: Patients recover faster with minimally invasive spine surgery because of the use of small incisions. Larger incision used in open spine surgery prolong recovery.

  • Local anesthesia: Conscious intravenous (IV) sedation with a local anesthetic is required in MISS, which is less risky than general anesthesia in open surgeries.

  • Less scarring: In MISS, less internal or external scarring occurs compared to open spine surgery.

  • Less blood loss: A small amount of blood is lost in MISS, while in open spine surgeries, a massive amount of blood may be lost, leading to severe complications

  • Less post-operative complications: MISS has a lower chance of postoperative complications. Infections and the possibility of a failed back surgery syndrome are considerably decreased, while in open spine surgery, chances of complications are significantly higher.

Complications associated with open spine surgery:

  • Deep vein thrombosis.

  • Anesthesia-related complications are more likely.

  • Pulmonary embolus

  • Pneumonia after surgery

  • Damage to the nerves

  • During surgery, there is the possibility of blood loss that will require a transfusion.

Both physically and mentally, open spine surgery and the accompanying discomfort can be tremendous burdens. to a patient. The anxiety may begin the minute you decide to have surgery and may continue well afterwards. Furthermore, your physical reaction to open surgery-related stress may affect your body in a variety of ways, including:

  • An elevated pulse rate

  • An elevation in blood pressure

  • Stress hormones are released.

  • Reduced blood flow to particular parts of the body

  • Breathing that is shallow or fast which can lead to lung problems

Other advantages of minimally invasive spine surgery help to minimize stress.

People often experience pain in the neck, upper, and lower back at some point in their lives due to spinal stenosis, herniated disc, foraminal stenosis, facet joint problems, and other pathologies. Patients find incredible difficulty walking, sitting, or standing for long periods of time. The patient may be unable to work or engage in everyday leisure activities due to the discomfort.

Suppose you're one of the individuals whose spine conditions hasn't responded to conservative treatments like physical therapy or medications, and your pain is chronic. In that case, MISS may be the best choice for you. It is used to treat a variety of painful spinal diseases, including:

  • Sciatica

  • Discs that are bulging, protruding, extruded, or ruptured

  • Narrowing of the spine

  • Stenosis of the foramen

  • Facet joint disorder

  • Chronic backache

  • FBS syndrome (failed back surgery)

  • Annular tear

  • Degenerative disease of disc

  • Vertebral compression fracture

  • Tumor of spine


MISS is a fantastic choice for those who have exhausted all other options for spine surgery, including open spine surgery, which is not only more invasive but may results in greater complications. Minimally Invasive Endoscopic spine surgery attempts to decrease the need for future surgery by relieving pain, avoiding spinal fusion, and maintaining the patient's spinal structure.


  • McClelland, S., 3rd, & Goldstein, J. A. (2017). Minimally Invasive versus Open Spine Surgery: What Does the Best Evidence Tell Us?. Journal of neurosciences in rural practice, 8(2), 194–198.

  • Fuchs, K. H. (2002). Minimally invasive surgery. Endoscopy, 34(02), 154-159.

  • Hansen-Algenstaedt, N., Kwan, M. K., Algenstaedt, P., Chiu, C. K., Viezens, L., Chan, T. S., ... & Schaefer, C. (2017). Comparison between minimally invasive surgery and conventional open surgery for patients with spinal metastasis: a prospective propensity score-matched study. Spine, 42(10), 789-797.

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