Traditional surgery in Orthopaedics and Spine surgery involves incising the skin, dissecting muscles, nerves and blood vessels, which can unfortunately give rise to post operative pain and possible issues with wound healing. To minimise these issues, surgery through small incisions or through key holes were developed few decades ago and now being popularised in select centers. Also, in certain situations, as in surgeriesinside joints (arthroscopy), the visualisation of tissues could be better than traditional surgery. This type of surgery is called Minimally invasive surgery.
Minimally invasive surgery (MIS) can be done through key holes (small stab type incisions) as in the case of Arthroscopic surgery, which is surgery done inside joint spaces or Endoscopic spine surgery, which is done mainly for disc problems in spine. MIS can also be done using small incisions in spine as well as bones and joints. Examples in spine include microscopic spinal surgery done with the aid of microscope for disc problems and the minimally invasive spine surgery done for spinal trauma and fusion surgeries of spine, where special instruments are used to fix the spine through very small incisions. Examples of this type of surgery in Orthopaedics include Minimally invasive trauma surgery and Minimally invasive Partial and Total joint replacements.
Here again special instruments are used to perform these surgeries through very small incisions.
So, the inevitable question arises… Can every Ortho and Spine surgery be done by this method?
It is standard practice in an advanced Ortho and Spine Center like ours, we try and do most surgeries through this approach as the benefits are obvious. Of course, not every surgery can be done by these methods as some surgeries do require wide exposure of tissues. Also, MIS surgeries require specific specialist training for the surgeon who is performing, as the orientation of tissues during surgery can be quite different in minimally invasive surgery as compared to open surgery. The equipments required to perform these surgeries are also quiet different compared to traditional surgery and often these equipments are expensive as they might have to be imported. So, only specialist centers are able to offer these surgeries for Ortho and Spine problems and if MIS is performed well, the immediate post operative pain relief and long term results could be superior and also minimize the risk of complications, compared to traditional surgery.
-Dr S S Kumar
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