Where minimally invasive spine surgery is headed: 4 key questions answered


Reginald J. Davis, M.D., FAANS, FACS, Director of Clinical Research at Tampa, Fla.-based Laser Spine Institute, discusses his study about minimally invasive spine surgery and where the minimally invasive spine field is headed.

Q: What implications does the study have on the spine field? How can these findings help bring minimally invasive spine surgery to more patients?


Dr. Reginald J. Davis: Our new research analysis, titled Advantages of Minimally Invasive Decompression Through Laminotomy and Foraminotomy, evaluated 500 Laser Spine Institute patients suffering from lumbar spinal stenosis over a two-year period and found substantial benefits for patients who underwent outpatient minimally invasive spine surgery for a laminotomy foraminotomy decompression procedure with us. One of the most compelling aspects of the study is that the patients studied were consecutive and were analyzed regardless of pathology, age, weight or any other factors. We are excited about this research because it reaffirms the efficacy of spine surgery performed in an ambulatory surgery center setting and the advantages of minimally invasive spine surgery overall.


Q: What are the economic benefits of the MIS procedure, especially with the shorter operative times and lower complications?


RD: The benefits of a minimally invasive approach to spine surgery, for both surgeons and patients, are well recognized and documented in the literature. In general, minimally invasive spine surgery utilizes a smaller incision and involves less tissue dissection than traditional spine surgery. As our study demonstrates, this distinction alone results in reduced muscle and soft tissue damage, reduced blood loss and structural disruption, shortened recovery time and a more rapid return to usual activity. Typical exposure to hospital pathogens and other hospital related complications and adverse events are completely avoided in the ambulatory surgery setting.


With outpatient minimally invasive spine surgery, patients do not need to spend the night at the center and spend less time in operating and postoperative rooms. Our minimally invasive spine surgery patients generally have a small incision and shorter recovery time, which allows them to get back to their jobs and families faster.


Q: How can surgeons incorporate minimally invasive outpatient spine surgery into their practice?


RD: If a surgeon was interested in adding minimally invasive outpatient spine surgery to their practice, my first recommendation to them would be to make sure you're doing it for the right reasons. At Laser Spine Institute, we stress a model that emphasizes the patient experience, and we take great strides to ensure the medical and corporate professionals we add to the team take that to heart. It's important to align yourself with those who believe in your mission, so hiring the right staff is incredibly important.


It is imperative that the vetting of equipment, staffing and scheduling takes place prior to adding spine procedures to a practice. This includes everything from admitting, medical screening, anesthesia, nursing and post-op concerns on the medical side. For surgeons who are interested in learning more about minimally invasive spine surgery, fellowships and peer-reviewed research are an excellent place to lay the foundation.


Q: Where do you see minimally invasive spine surgery headed in the future?


RD: While open back surgery has traditionally been the treatment of choice for lumbar stenosis, the study shows that minimally invasive spine surgery should be considered an optimal method of treatment. The smaller incision, more direct technique and reduced trauma to the muscle and supporting tissue with proper expertise produces sufficient decompression with significant reduction in levels of pain and disability.


I see minimally invasive spine surgery becoming the optimal solution for patients suffering from chronic neck or back pain. Our minimally invasive spine surgery is often the clinically appropriate first choice and provides many advantages versus open neck or back surgery. Studies like this one illustrate that minimally invasive procedures yield positive results and outcomes that improve the overall quality of life for the patient.


I also believe that as additional studies around minimally invasive spine surgery are released to the public, more surgeons and facilities will incorporate minimally invasive spine surgery into their practice.


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