Is Cervical Disc Replacement The Best Choice? Top Spine Doctor Shares Insight
Years ago, the phrase “spine surgery” would send shivers down…well…the spine. In recent years, however, technological advances have progressed so far that many back conditions can be treated with procedures that deliver excellent results through much smaller incisions with less risk. These procedures are often referred to as Minimally Invasive Spine Surgery (MISS).
To better understand MISS, we recently sat with Dr. Paul Jeffords, a board-certified surgeon whose expertise in spine surgery has made him a 2018 Castle Connolly Top Doctor. He explains that spine surgery has traditionally been performed as “open surgery”. This means the area being operated on was opened with a long incision—frequently as long as six inches—to allow the surgeon to see and address what was going on beneath the skin and muscle tissue.
With the minimally invasive approach, the long incisions of open surgery—and the potential problems they could cause—are no longer the norm. “It’s no longer necessary to move sizable portions of skin, muscle, and tissue to see what’s going on around the spine,” Dr. Jeffords asserts. “This means there is reduced potential for damage to the muscle tissue, less bleeding, less pain after surgery, and a faster recovery time.”
This begs the question, how does Minimally Invasive Spine Surgery work?
Dr. Jeffords walked us through a typical procedure. The first step is to make an incision—usually about an inch long—along the spinal column near the pain area. The surgeon then inserts a tubular retractor—a rigid tube-shaped tool—through the small incision. “This allows the surgeon to ‘tunnel’ to the problem area by gently pushing aside the muscle and tissue around the spine,” he explains. “During the procedure, the tubular retractor also holds the muscles open and in place, so the surgeon can insert smaller tools—sometimes including a tiny camera—to work on the spine.”
With open surgery, the surgeon would have been required to move the muscle to get a clear view of the spine. “In open surgery, the doctor is dissecting your spinal muscles to pull them away from your bones,” Dr. Jeffords explains. This movement can result in scarring of the tissues, leading to more pain and stiffness after surgery.
“The goal is to significantly reduce the patient’s pain, allowing them to return to an active life in a short period of time,” - Dr. Paul Jeffords
Although minimally invasive techniques are being used to address a wide range of spine procedures that previously only open surgery could resolve, the approach is frequently used for spinal decompression. “Minimally invasive spinal decompression is a technique that can provide relief of back and leg pain caused by herniated discs, spinal disc degeneration, spinal stenosis, or spinal arthritis and instability,” Dr. Jeffords explains.
Patients seeking minimally invasive spinal decompression have usually tried conservative treatments like medication, physical therapy, and spinal injections to relieve their pain. But when those approaches don’t solve the problem, minimally invasive decompression can be a very good option.
Regarding recovery, the typical minimally invasive spine surgery patient returns to office work in less than five days; starts physical therapy roughly two weeks following surgery; and returns to physical activities—like golf, tennis, running, and weight-lifting—about six weeks after the procedure.
Still, to help ensure the optimal results, Dr. Jeffords advises candidates to work with a board-certified surgeon who has vast experience with the procedure. Board certification means the surgeon has the education, experience, and skills to deliver safe and effective results. With this in mind, some best practices for patients include:
Confirming the physician’s board certification
Reading reviews of the surgeon being considered as a partner
Speaking with the surgeon about the procedure to ensure an in-depth understanding of what is involved before and after the surgery
With a skilled surgeon, patients who select minimally invasive spine surgery can anticipate a lot of big-time benefits: less time in surgery, less pain after surgery, less scarring, quicker recover, less rehabilitation, and reduced need for pain medication. “The goal is to significantly reduce the patient’s pain, allowing them to return to an active life in a short period of time,” Dr. Jeffords concludes.