Minimally invasive surgery is performed with a series of steps designed to ease trauma to patients and promote faster healing. Several procedures of this nature involve orthopedic and neurological techniques since nerves, bones, joints, and soft tissues can all play a role in how and when pain is experienced. Minimally invasive neurological and orthopedic surgery is performed to ease a patient’s pain and restore normal function of the affected part of the body.
Most instances of spine-related pain that require surgery are related to some type of nerve compression. Care must be taken when easing this pressure to avoid damaging the affected nerve and other nearby nerves. With a minimally invasive discectomy, for instance, small incisions are made and special instruments are used to access the affected area without significant trauma to adjacent nerves and tissues. Decompression surgery may be necessary because of:
- Herniated or slipped discs
- Limited spinal spaces (spinal stenosis)
- Pressure on the sciatic nerve (sciatica)
If nerves exiting the spinal cord are affected, a minimally invasive procedure called a foraminotomy may be performed. It may be done to remove bone spurs, scar tissue, or make surgical adjustments to thickened ligaments. During a minimally invasive laminectomy, the outer bony covering of a vertebra (lamina) is removed to provide more room for nerve roots
Arthritis is the most common condition that may affect any joint in body, although it tends to more problematic when knees, hips, and parts of the spine are involved. With shoulders, joints can be damaged from a rotator cuff injury. Injury to any of the four ligaments supporting the three bones of the knee may compromise the joint. Fractures can also make joints unstable or damaged to the point where surgery becomes necessary.
A minimally invasive procedure called a facet thermal ablation may be done to deaden nerves triggering pain in the joints that support the spine (facet joints). In some instances, an entire joint may need to be replaced. This type of surgery is most likely to involve knee, hip, and shoulder joints, although it can also be performed on wrists and ankles.
Muscles, Tendons, and Ligaments
ACL (anterior cruciate ligament) repair is one of the most common minimally invasive procedures performed to correct damage to tissues that support a joint. Similar techniques may be used to surgically repair Achilles tendon ruptures in ankles or fix rotator cuff tears in shoulders. Neurological damage in hands or wrists is sometimes related to pressure from inflamed, twisted, or damaged tendons. Surgery may be necessary to provide relief for nerves.
Similar damage to nerves near muscles, tendons, and ligaments can occur from injuries involving deep cuts or broken bones that pierce the skin and sever nearby nerves. Pressure or stretching injuries can also cause fragile fibers in nerves to become irritated or break. If a nerve is cut, the end closest to the brain will survive, but immediate action is necessary to attempt to restore the connection. Such injuries may also result in the formation of painful nerve scars (neuromas). Corrective surgery may involve:
- Repairing the insulating cover on the nerve
- Taking steps to encourage new nerve growth
- Repairing the injured nerve with a nerve graft
Spinal Cord Injuries
Spinal cord injuries often result in neurological and structural damage. Whether or not SCIs can be corrected with minimally invasive procedures will depend on the extent of the damage.
If the spine becomes unstable, fusion surgery may be necessary to join (“fuse”) adjacent bones together. Minimally invasive versions of fusion surgery involve techniques such as finding natural pathways to insert screws (pedicle targeting) to avoid unnecessary disruption to nearby tissues. Such procedures use smaller incisions to insert instruments and a special live X-ray (fluoroscopy) to allow the surgeon to view the affected part of the spine.
The goal with any type of neurological or orthopedic surgery is to restore a patient’s quality of life. The specific type of surgery performed will depend on the issue that needs to be corrected and the extent of the damage to the affected bones, joints, muscles, tendons, ligaments, or nerves. Most common surgeries performed with minimally invasive techniques allow patients to enjoy fewer complications and shorter recovery times.