Neurological Health

Keyhole Spine Surgery - a Boon to Spine Health

Written by
Dr. Chandan Mohanty
and medically reviewed by iCliniq medical review team.

Published on Jul 07, 2016 and last reviewed on Sep 07, 2018   -  2 min read

Abstract

Abstract

Spinal diseases are the second most common reason for a medical consultation. About 80% of world population will have low back pain at some point in their lives. Hence, anticipating this problem and with a goal to reduce postoperative pain and to improve recovery times, the keyhole spine surgery was first introduced in 1997. It is currently the most popular and most commonly performed type of spine surgery in the developed world.

Spinal diseases are the most common cause of the disability worldwide, measured using disability-adjusted life year (DALY) parameter. Contrary to popular perception, the peak incidence of spinal disorder is not seen in the elderly but rather in the age group of 35 to 55 years. With an increase in life expectancy, it is clear that spinal diseases may reach an alarming proportion. Traditionally, spine surgeries have required a long incision and often unnecessary exposure of a large part of the normal spine leads damaging the muscles and surrounding tissues that are important in maintaining spinal stability. Invariably these patients need prolonged hospital stay and may take 3-6 months or longer to resume their day-to-day activities.

Hence, keyhole spine surgery was introduced.

Keyhole Spine Surgery:

  • Keyhole spine surgery or minimally invasive spine surgery is the method of treating spine diseases without causing widespread injury to surrounding tissues.
  • Keyhole spine surgery can be performed in various ways using tubular dilators, endoscope, surgical microscope, etc. Yes, some of the surgical incisions can be covered with just a band-aid!
  • This surgery requires a high level of expertise and cutting edge technology. Currently there are only a few centers in a country having the expertise to perform this procedure.

Diseases That Can Be Treated with Keyhole Spine Surgery:

  1. Lumbar radiculopathy, which is commonly known as slipped disc or disc herniation or back pain or sciatica.
  2. Spinal stenosis or degenerative spinal diseases, neurogenic claudication.
  3. Cervical radiculopathy that is neck pain with sharp arm pain.
  4. Spondylolisthesis.
  5. Spinal instrumentation such as percutaneous screws and rods.
  6. Osteoporotic fracture vertebra in vertebroplasty and kyphoplasty.
  7. Specific types of thoracolumbar spinal injuries.
  8. Spinal infections.
  9. Certain types of spinal tumors (epidural and intradural extramedullary).
  10. Tethered cord, a type of birth defect affecting the spine.

Procedure:

  • As with any spinal disease, the correct diagnosis is reached based on the combination of patient symptoms, examination and radiological tests like x-ray, MRI (magnetic resonance imaging) and CT (computed tomography) scan.
  • After proper patient selection, the procedure involves making a small incision over the spine and then using tubular dilators the desired surgical procedure is performed through an endoscope or surgical microscope, without extensive dissection, cutting or devitalizing muscles in contrast to traditional spine surgery.
  • The surgeon may also use sophisticated devices like computer-assisted neuronavigation, intraoperative C-arm, O-arm and nerve monitoring (intraoperative electrophysiology) making this procedure extremely safe. Screws and rods can also be used if required.

Postoperative Care and Recovery:

  • Patients undergoing surgery for herniated discs and spinal stenosis are usually discharged the same day or next day, whereas patients undergoing surgery for other reasons may take 3-5 days.
  • Physiotherapy with back and core strengthening exercises are usually started after 4-8 weeks.
  • A neurosurgical spine center has a multi-disciplinary team of neurosurgeons, neurointensivists, electrophysiologists, radiologists, physiotherapists and rehabilitation specialists who manage the patients to ensure maximum benefit, recovery and a better quality of life.

Advantages of Keyhole spine surgery:

  1. Less tissue trauma and blood loss.
  2. Minimal tissue scarring and less postoperative pain.
  3. Shorter hospital stay (discharge on the same day of surgery is possible in selected cases).
  4. Faster recovery and ability to resume day-to-day work in a shorter time. Patients can walk and move around the same evening of surgery.
  5. Smaller surgical incision, may be as small as 2 centimeters.

Consult a neurosurgeon online to know more about keyhole spine surgery --> https://www.icliniq.com/ask-a-doctor-online/neuro-surgeon

Last reviewed at:
07 Sep 2018  -  2 min read

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