INDUSTRY INSIGHT
Minimally Invasive Surgery
SURGERY OF THE SPINE
S
urgery of the spine has come a long
way, especially in the past 10 years.
Technology and improved surgical
techniques have allowed for spine surgery
to join the world of minimally invasive
surgery. Laparoscopic abdominal surgery has
transformed procedures such as gall bladder
removal, appendectomy, colon surgery, and
virtually all abdominal and pelvic surgeries to
outpatient or overnight stays in the hospital.
Arthroscopic hip and knee surgery make all
but joint replacements minor procedures.
Minimally invasive surgery has the
advantages of smaller incisions, quicker
healing, less pain, less bleeding, and lower
risk of infection and other complications.
Now with MRIs giving precise images of
spinal problems, experience gained from
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Dr. Eric Nabors ›
analyzing the results of decades of surgery,
and better surgical instruments, the majority
of spinal surgery can be performed by
minimally invasive techniques.
Herniated discs in the low back can be
removed through cannulas (small tubes) that
only require a tiny incision and no cutting of
muscle. There is no such thing as arthroscopic
spine surgery (that only applies to surgery in
a joint such as the knee) but this is close. It is
done as an outpatient. Patients can be back
to work in as little as a few days.
Herniated discs and pinched nerves in the
neck are treated through one-inch incisions,
often as an outpatient.
Compression fractures, which affect
mostly older patients with osteoporosis, can
be treated with an outpatient procedure
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called kyphoplasy. It is performed by placing
very large needles into the compressed
(broken/fractured) vertebrae (spine bone),
then placing a deflated balloon into the
vertebra and inflating it to re-expand the
bone. The balloon is then removed and bone
“cement” is injected to fill the cavity created
by the balloon. Medicare even approved
this procedure to be performed in properly
equipped offices.
Even laminectomies and fusions that used
to require 6 to 8-inch incisions and four to
five-day hospital stays can now be performed
through 2 to 3-inch incisions and hospital
stays of only one or two days.
Chronic back and leg pain, without a
correctable cause such as unsuccessful
prior surgery, can be treated with a hightech, minimally invasive procedure called
spinal cord stimulation (also known as
neuromodulation). A tiny electrode is placed
onto the spinal cord and an electric current
then “short circuits” back and/or leg pain.
“What about laser surgery?”
The short answer is...gimmick. You won’t
find laser spine surgery at any major medical
center.
For those intrigued by laser surgery, I
encourage you to google Hulk Hogan’s
experience at the laser spine center, or the
Bloomberg article regarding lawsuits at the
center.
This Industry Insight was written by Dr. Eric Nabors.
Dr. Eric Nabors is a native of the South Hills of Pittsburgh.
He went to medical school at Pitt. After completing a
residency in Boston he performed a Fellowship in spinal
surgery at the University of Pittsburgh Medical Center.
He was in practice at South Hills Orthopaedics from 1995
until this year when he joined Advanced Orthopaedics
and Rehabilitation. He is excited to bring cutting edge
treatmen Ё