What do we mean by Minimally Invasive or Key Hole Spine Surgery ?

The world of medical science has been taken over by a storm of minimally invasive surgeries. May it be any field of medicine, all scientific evidences has started promoting minimally invasive surgery. A surgery which we at our household  know by name of "Key Hole Surgery". 

My question today is , Do we really understand what do a common man mean when he thinks about "key hole surgery" and what actually the science says about it ! what i mean to say is ... there is difference between a common perception amongst mass and the actual scientific meaning of minimally invasive surgeries. 

I can not narrate to a great extent about other fields as they are not my subjects... but what i do understand and practice is spine surgery. So, let us try to understand what should we mean or understand when we talk about "minimally invasive spine surgery (MISS)"!

What is General perception about "Key Hole Surgery"

what i have found during my day to day interactions with my patients is , most of them feel that a key hole surgery is a surgery where a procedure is being performed without making a cut or an opening on or around one's spine. Most of them have an impression that , a surgeon who operates a key hole surgery, fires some kind of a LASER which by virtue of its tissue dissolving properties corrects the pathology in spine. 

The scientific fact is far far away from this perception. What we mean scientifically by Minimally invasive or a key hole surgery, the meaning itself is hidden in the name. A surgery which invades your body minimally as compared to traditional open surgery is called a minimally invasive surgery. 

The idea of minimally invasive spine surgery is to preserve the normal physio-mechanical properties of spine and its surrounding structures. The MISS surely deals with a very small incision but the core idea is to preserve the surround muscle crepe that stabilises the spine ! MISS does the same thing to pathology as it was in an open surgery but the approach is different. The approach that aims at preserving surrounding muscles, joints and ligaments. 

So , in a nutshell MISS is not the commonly perceived non-open surgery but a surgery with enough opening so as the pathology can be corrected with least possible tissue damage. 

what are the advantages of MISS ?

1) minimal tissue damage
2) significantly reduced chances of infection as compared to open surgeries
3) minimal blood loss
4) rapid recuperation from surgery
5) early return to work

At the same time , it is important to know that , the surgeon has to be proficient enough to perform a quality MISS. MISS has a steep learning curve. So, it is important to ask in detail to your surgeon about his experience in minimally invasive spine surgery. 

What i would recommend is , do basic research about the surgery you had been advised and know in detail about the minimally invasive procedure for that particular surgery. And when you know that , you can ask pertinent questions to your surgeon about the said MISS procedure. 

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