As we have read in the open surgery section, it entails skin incision, muscle dissection off the bony attachment, bony removal, and then reaching target area.
Minimally invasive spine surgeries (MISS) have a small tube passing through the skin which pushes the muscle aside and reaches the target area thereby circumventing the need for muscle dissection and extensive bone removal.
Minimally invasive spine surgeries (MISS) performed using tubular retractors aim at preventing any soft tissue damage while operating on the affected vertebra while also keeping the exposed area to the bare minimum. Instead of incising through the muscles, a tubular retractor carefully dilates them away from the operation site isolating the part of the spinal column. Tubular retractors work through small incisions which are often termed as ‘ports’, and also facilitate the use of endoscopic devices when necessary.
With the help of these efficient tubular retractors, essential types of spine surgeries like discectomy and laminectomy can be performed with less tissue damage and pain as microsurgical tubular discectomy (MTD), and microsurgical tubular laminectomy (MTL) (over the top decompression).
Tubular Retractor Surgery Procedures:
Depending on the necessary positioning, utility, and number of tubular ports, this surgery can be performed to treat various spinal conditions in distinct ways. The most common and efficient methods of tubular surgery which our spine specialist in Mumbai is widely known to perform are:
Tubular Microlumbar Discectomy:
Tubular retractors are placed and retract the skin, muscle. Small bony opening is made to reach the disc and disc fragment in removed. The entire time of surgery is about 40 mins and patient can walk immediately after anesthesia wears off completely.
It is very comfortable for the patient and patient can resume their work immediately after discharge as there is minimal post operative discomfort.
Tubular Surgery For Metallic Fixations:
Tubular retractors can be used to fix prosthetic screws and rods to stabilize the spinal column without damaging the muscles and other soft tissues over the spine. MIS TLIF, MIS PLIF, Percutaneous Pedicle screw fixation are some of the surgeries done with MIS techniques.
Tubular surgeries work through much smaller incisions made over the skin without cutting through the underlying muscles.
With the help of fluoroscopic images, our spine specialist uses guidewires which are inserted through the skin and into the target vertebrae to create a path for the screws to be fitted at different points. These screws have a unique extender over the top that helps the surgeon in passing fixing rods used to connect and fasten the screws.
The screws are inserted over the guidewires and are fixed into the vertebrae without damaging the muscle layer. Once the screws are in place, the protruding extenders are cut off, and the incisions are closed.
Today, up-coming robotic and imaging-guided technology can also be used to place the fixations more accurately.