Minimally invasive lumbar spinal fusion is similar to traditional lumbar spinal fusion, but it uses smaller incisions and causes less damage to the surrounding tissues during surgery.
As with traditional lumbar spinal fusion, there are many specific techniques available to try to fuse the vertebrae together using minimally invasive techniques. This can be done through the abdomen, from the back, from the side, or with any combination of these.
Minimally invasive lumbar fusion through the abdomen uses four small incisions, approximately ½ inch in length. A fiber optic viewing camera is used, similar to other minimally invasive procedures including laparoscopic gallbladder or appendix removal.
Fusion with screws and rods can be performed through the back using several 1-2 inch incisions. In these cases a series of increasingly larger dilators are inserted through the incisions to help spread the muscles apart. Once the muscles have been moved away, the screws and rods can be placed through the dilator tubes. In some cases an operating microscope is used to help the surgeon see more clearly.
One of the most recent advances in minimally invasive lumbar spinal fusion is the ability to perform fusion surgery through the patient’s side. There are several techniques that allow the surgeon to make a small incision, approximately 2 inches in the patient’s side, directly over the planned fusion site. The muscles are then carefully moved aside, and a series of increasing larger dilators are inserted down to the lumbar spine. Specialized instruments can then be used through the dilator tube to remove the intervertebral disc and place a bone graft or metal or plastic spacer in its place. This technique is typically combined with a procedure from the back to place rods and screws for additional support.