Minimally invasive spine surgery: Less pain with a quicker recovery

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Only eight to 10 years ago, even the most advanced healthcare systems were cautious about promoting and performing minimally invasive spine surgery (MISS). Today, Dr. Abraham Schlauderaff of East Falls Neurosurgery and Spine Clinic frequently performs minimally invasive spine surgery at EIRMC.

The hallmarks of MISS are smaller surgical incisions, less damage to muscle and bone, more preservation of movement, and faster recovery. Over and over, Dr. Schlauderaff has witnessed the benefits MISS offers to his patients suffering from back pain.

“To me, the best thing about minimally invasive surgery is quick recovery. Patients feel better quicker, heal quicker, get up and moving sooner, and get home faster,” he says. “Minimally invasive lumbar surgery is often a same-day surgery. Patients having traditional fusion surgery spend three to five days in the hospital; with MISS, they can often go home after just one day, three at the most.”

“Recently I performed a minimally invasive discectomy on a woman to replace her discs. Before surgery, bulging discs caused severe shooting pain down her legs and she couldn’t walk. When she woke up from surgery, she had no pain — no post-surgical pain, no need for pain medication, and had no more pain in her legs. Just three weeks after surgery, her life is back to normal. She’s completely pain-free.”

Herniated or bulging discs in the spine are a common cause of neck and back pain. During MISS discectomy, part or all of the herniated disc is removed through a small incision and a tube that bypasses the tissue and muscles around the spine. Metal plates with a plastic polymer core replace the damaged disc. The plastic polymer absorbs shock like the original disc, resulting in more natural spinal movement.

“I do a lot of disc replacements, especially in those under age 70,” explains Dr. Schlauderaff. “The outcomes are much better than with fusion, especially in the neck. The patient retains more motion and has fewer complications over time.”

Sometimes, spinal fusion is the best treatment option for a patient. Dr. Schlauderaff uses MISS as often as possible for these surgeries, or a combination of traditional and MISS techniques. “It’s a holistic approach,” he says. “Whatever combination causes less damage (to the surrounding muscle and tissue).

“I see patients who have had previous spine surgeries that did not work. Their scars are four inches long or more. When I perform the revision surgery, my incisions are usually only 2 cm (or 3/4 inch). That means less blood loss, less risk of infection, less or no post-surgical pain, and less time in the hospital.”

As an avid runner, hiker, and camper himself, Dr. Schlauderaff finds it especially satisfying to see his patients after spine surgery.

“Before surgery, they can’t walk, they can’t hold their kids, they can’t do normal daily activities. When they come back to see me a few weeks after surgery, they have their life back, and they’re so appreciative. It’s very gratifying.”