Minimally Invasive Spinal Surgery (MISS) is all about smaller incisions and less tissue disturbance, in the interests of faster post-operative recovery. Of course these aims must be balanced against the need for the surgeon to have sufficient access to achieve the aims of relieving pain and producing a durable and lasting result.
Benefits of Minimally Invasive Surgery were hoped to include:
- Less pain
- Faster recovery
- Shorter hospital stay
- Aesthetically better
Some operations are done minimally-invasively, to good advantage. However it has since become clear to many surgeons that certain operations may have better long-term results for the patient if they are done in "open" fashion.
In particular, Dr. Brazenor no longer recommends minimally-invasive TLIF. In his opinion the mechanical result is inferior to that obtained by open operation. This particularly applies to "spinal balance", which is the posture of the spine after operation. With open operation the surgeon has a much greater ability to restore the normal spinal posture, very important for pain-free function of the spinal segments above those which have been operated. Minimally-invasive spinal surgery merely for the purpose of shorter skin incisions has, in Dr. Brazenor's experience, resulted in some instances of mechanically-inferior results, to the patient's detriment.