Minimally invasive spine surgery is a type of spine surgery that requires smaller incisions and does less damage to muscles and tissue.
The spine, spinal nerves, discs, and vertebrae are all situated under layers of muscle and tissue. Accessing these parts of the body requires extensive maneuvering and sometimes more complicated cutting procedures.
However, spine surgeries that require less cutting and moving have become more common thanks to advanced tools and robotics. These surgeries are often called
This article will provide more detail on this type of surgical procedure, who qualifies and how much it may cost, and what recovery may be like for those who have this procedure.
MISS allows surgeons to stabilize the spine, discs, joints, and nerves. These are the same goals as traditional open back surgery. However, the goal of MISS is to do this while minimizing the damage to the tissues and muscles in and around the back.
The benefits of MISS include:
- less trauma or risk of muscle damage
- faster surgery
- fewer risks
- shorter recovery time
- less damage to the skin from small incisions
- less blood loss
- lower risk of infection
- less rehab or physical therapy needed
- reduced need for pain medications
Several common back conditions can be treated with MISS. These include:
- degenerative disc disease
- spinal deformities such as scoliosis or sagittal imbalance
- bone spurs
- herniated discs
- spinal stenosis
- spinal infections
- spinal instabilities such as spondylolisthesis
Some back conditions won’t qualify for MISS. A doctor or healthcare professional can review the options for treatments. MISS can be one of many treatments available to you.
Prior to your procedure, a surgeon will likely discuss what you can expect during the surgery. Each type of MISS is a bit different. Most will take 1 to 2 hours.
Depending on the condition, the steps of this surgery may vary slightly. However, this is the typical process:
- You’re prepped for surgery. This may mean changing into a hospital gown, confirming the procedure with the healthcare team, and receiving an IV or presurgery medications.
- You’ll receive an anesthetic in most cases. The type of anesthetic will depend on your surgery. Some people are able to have a local anesthetic. This only numbs a small part of the body. A general anesthetic will put you to sleep during the procedure.
- Surgery will begin. The doctor will start with one or more small incisions in the back or side.
- They’ll insert instruments or tubes. These help move tissue and muscle aside so they can access the part of the spine that will be operated on.
- Depending on the type of procedure that’s being done, they’ll then use additional instruments to correct, remove, or replace whatever is needed in the spine.
Types of MISS
There are several types of MISS. Some of these include:
- Screws and rods: This type of MISS uses X-ray images and guide wires to help the surgeon place screws and rods in the spin. These help stabilize certain areas of the spine. Once the screws or rods are in place, the surgeon will remove the guide wires and close the incisions.
- Discectomy: Spinal discs are soft tissue between the vertebrae. They cushion the spine during movement. Sometimes, the discs can expand and push out. This is called a hernia. Hernias can press on nearby nerves and cause pain. During a discectomy, a surgeon can remove or trim the herniated disc.
- Spinal decompression: Spinal stenosis is a common cause of pain, numbness, and tingling. It happens when the space in and around the spine narrows too much. A decompression procedure can remove bone or soft tissue to make more space and ease symptoms.
- Transforaminal lumbar interbody fusion (TLIF): Fusing parts of the spine together can increase stability and strength. During TLIF, a surgeon will place several screws in the vertebrae. The damaged disc and bone will be removed. The surgeon will then add bone material and fuse it to existing bone. This creates a new, stronger spine section.
MISS is considered a safer alternative to open back surgery. But there are still some risks associated with it. These risks include:
- blood clots
- a reaction to an anesthetic
- infections at the incision sites
- injury to tissue or nerves
- spinal fluid leak
In some cases, the initial MISS can’t be completed. A second surgery may be needed. This could be another MISS or open surgery.
MISSs are increasingly popular because they are easier on the person. They’re also considered safer and still highly effective.
What’s more, people treated with MISS experience fewer adverse outcomes during surgery and after, according to this
Back surgery of any kind requires recovery time. But people who have MISS often have a shorter recovery window.
A doctor will discuss limitations and restrictions with you. These may include:
- avoiding showers for one or two days after surgery
- avoiding baths for 1 month after surgery
- avoiding lifting heavy objects for 1 month or more after surgery
- avoiding strenuous work for 1 month or more after surgery
MISS reduces tissue damage during surgery. That usually makes recovery easier for individuals who have this type of surgery. Risks, including infections or nerve damage, will delay recovery, so each person’s recovery will differ.
Some people will need to work with a physical therapist after surgery. These healthcare professionals will be able to advise you on restrictions and limitations.
A doctor may also prescribe some mild pain relievers to take in the days immediately after surgery. Swelling and inflammation can occur. Rarely, doctors may prescribe narcotic pain relievers.
MISS can be a costly procedure. Total costs can vary based on where you are, the type of medical venue you use, and any recovery expenses.
However, MISS is often cheaper than open surgery. That’s because your stay at the hospital is typically shorter. You get to leave the hospital sooner than if you have a more invasive open surgery.
This same report says minimally invasive TLIF surgery has an average cost of $70,159. The average cost of the open version of that same surgery is $78,444.
If you have health insurance, some of the cost may be shared with the health insurance company. You’ll have to pay deductibles and copays, which may make the out-of-pocket cost higher.
If you’re looking for treatment for back pain or related issues, a doctor may have an existing relationship with a back surgeon experienced in MISS. You can consult a doctor and healthcare team for recommendations. You can also explore Healthline’s FindCare tool.
MISS has been used more frequently in the last 2 or 3 decades. That’s largely because this approach minimizes damage to tissue and muscles while also getting results equivalent to open back surgery.
Indeed, many people who have this surgery are able to recover faster. Plus, the surgery is often successful with results similar to more invasive back surgeries.