Minimally Invasive Spine Surgery| Plano, TX| Michael Hisey, M.D
Minimally Invasive Spine Surgery| Plano, TX| Michael Hisey, M.D

Hi I’m Mike Hisey, orthopedic spine
surgeon with the Texas Health spine and Orthopedic Center. Minimally invasive
spine surgery is a way of accomplishing a spine surgical procedure with the
least damage to normal tissue possible. So you could do though the least amount
of cutting, the least amount of dissecting of muscles, the least amount
of disturbing of bone but you still have to accomplish what you’re trying to
accomplish with the operation. It may involve smaller incisions, it may involve
x-ray guidance, it may involve microscopes, magnification many things
that allow us to do the operation without maybe seeing everything around
the area. We just see what we need to see to get the operation done. An example of
a minimally invasive surgery is something like I’m microdiskectomy
which we used to do diskectomies by exposing above and below the disk space
looking down into the incision and seeing all the bony landmarks figure out
where we are then. Now we can make a smaller incision and not have to see all
the landmarks but know by using our x-ray where we are and then we can do the same
operation through a small incision. And then beyond that we go to tubes and
beyond that we can now do it through sometimes a scope so put the scope
inside the incision and that would lead to sometimes an eight millimeter
incision for an operation that used to take maybe a three inch incision. The
benefits of minimally invasive spine surgery hopefully we’re taking care of the
same problems, we’re getting the same result in terms of pain relief but often
the patient will experience less post-operative pain, take less narcotic
medication or other medication postoperatively and also hopefully
recover more quickly and get back to their activities more quickly. So if
there are any pitfalls of minimally invasive surgery it’s that you may not
get everything you’re after so that’s why you have to really plan carefully
and know exactly what you’re going after before you’re there because you can’t
look around for everything else. You know when you are doing a traditional
abdominal surgery used to be that they would open the belly all the way up and
look around at everything. Now with the endoscopic surgery they
don’t do that they look right at thereafter so you have to have a really
good plan to begin with or you’re gonna miss something that you might need to
take care of. We plan for these surgeries with sometimes a number of modalities
the first thing is we start with a physical exam so we know what what is
going on with the patient, what they’re complaining about, what symptoms are
really bothering them and correlate that with
their preoperative imaging. We will get x-rays, MRI scans all of which can help
us to define what’s hurting and if there’s a couple things that look like
they might be hurting or trying to tease that out
well sometimes use injections such as selective injections to block a
particular nerve and see if that relieves the patient’s symptoms and if
it does that helps us confirm that that’s what’s hurting and if it doesn’t
maybe we don’t even need to treat that level maybe we just need to focus on the
ones that do give them relief of symptoms. Oh there’s a whole list of
procedures that are minimally invasive so minimally invasive is not necessarily
just the band-aid procedure although some of those are minimally invasive
sometimes when the patient has a problem that would not respond to that and if
you put them through that minimally invasive procedure you you get a
minimally effective procedure. You have to do the right operation for the right
patient. Really it’s a philosophy of taking care of patients where you do the
least amount of damage possible and at Texas Back Institute and at
the Texas Health Spine and Orthopedic Center there are many doctors who
perform minimally invasive surgery and have a minimally invasive philosophy
about the surgeries. So that really any operation you’re getting from them is
going to be the least invasive operation that accomplishes what you need.

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