Frequently Asked Questions
Is all minimally invasive surgery the same?
No. Many doctors get away with saying they do minimally invasive surgery because of the incision size. However, they use equipment that expands once inserted into your spine, which causes as much muscle tearing and pain as traditional open back surgery. At the Minimally Invasive Spine Institute we do not use expandable retractors. Our equipment allows us to go right between the muscle, thus not tearing them at all.
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What are the advantages of a minimally invasive procedure?
The primary advantage is that it is highly effective and very low risk since there is no interference with the muscles, bones, or joints or manipulation of the nerves in your neck and back area. Since only small probes are inserted through the muscle at the incision, there is very little if any scarring in or around the nerves. Because many of The Minimally Invasive Spine Institute's procedures are performed on an outpatient basis, you may be allowed to return home the day of the procedure. Many patients worldwide fly in for the procedure and fly out the next day.
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Are the surgeons at The Minimally Invasive Spine Institute fellowship trained and board certified?
All the Minimally Invasive Spine Institute doctors are board-certified and fellowship-trained spine surgeons who specialize in endoscopic laser and minimally invasive spine procedures. These certifications are considered the highest level in medical specialty training in the spine field. Many other doctors performing these procedures elsewhere do not have this highest level of training in the spine and are neurosurgeons not trained to specifically work on the spine. The Minimally Invasive Spine Institute doctors dedicate 100% of their time to the spine, making them some of the best in the world.
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Why is a minimally invasive procedure at The Minimally Invasive Spine Institute better for me than other surgical options?
The Minimally Invasive Spine Institute doctors are board-certified and fellowship-trained spine surgeons who specialize in endoscopic laser and minimally invasive spine procedures. These certifications are considered the highest level in medical specialty training in the spine field. Many other doctors performing these procedures elsewhere do not have this highest level of training in the spine.
The Minimally Invasive Spine Institute doctors are pioneers in using the latest technologies such as lasers, tiny cameras, micro-instruments and probes to make a tiny incision (as small as 2 mm) with little to no muscle damage, which leads to little or no blood loss. These advances allow our highly trained spine surgeons to discharge our patients in many cases 2-3 hours after the procedure. In fact, The Minimally Invasive Spine Institute was the first in Texas to perform endoscopic (camera assisted) laser spine surgery as well as the first to do so with a 3mm incision. Many of the procedures performed by The Minimally Invasive Spine Institute require only local anesthesia and a Band-Aid®. This training and laser expertise allow The Minimally Invasive Spine Institute to do most types of spine procedures minimally invasively where other doctors can only do ONE TYPE of procedure in this fashion.
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Why don't more surgeons use these types of techniques?
Minimally invasive procedures are difficult to learn and even more difficult to perform. Many doctors are not trained or skilled enough to perform minimally invasive procedures. The Minimally Invasive Spine Institute doctors are revolutionizing the minimally invasive laser spine field and have gone through rigorous years of training. All have achieved board certification and are fellowship-trained spine surgeons who specialize in endoscopic laser and minimally invasive spine procedures. These certifications are considered the highest level in medical specialty training in the spine field.
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Who should consider a minimally invasive procedure?
Minimally invasive procedures are specifically designed for patients with herniated or bulging disks, degenerative disk disease, spinal arthritis, bone spurs, facet disease, pinched nerves, or spinal or foraminal stenosis, accompanied by the following:
- Recurring buttock, groin, back, neck, leg or arm pain with occasional numbness or weakness
- Pain that has not responded to conservative treatments; i.e., bed rest, pain medication, physical therapy, or muscle relaxants
- Problems confirmed by CT Scan, MRI Scan, Enhanced CT Scan, Myelography, or Discography
If you have any questions regarding your eligibility for a minimally invasive procedure, please fill out our form on the left side of any page of our website and one of our patient advocates will make contact to get you scheduled for a consultation with one of our doctors.
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What if I have already had one or more open back or neck surgeries?
WE CAN HELP – many of our patients have had one or more failed open back surgeries in the past. The Minimally Invasive Spine Institute's revolutionary small incision procedures can correct most conditions, plus remove unwanted hardware that is unneeded and/or causing discomfort. Scar tissue development from a previous open back surgery can also cause new and painful spine conditions and can be removed by The Minimally Invasive Spine Institute.
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How soon after the procedure can I resume my normal activities and/or go back to work?
Most patients feel immediate relief from pain during or following the procedure. Walking is permitted the same day and in many cases patients can be discharged from the hospital that day. While the minimally invasive procedure is frequently performed on an outpatient basis, your physician may recommend an overnight hospital stay. Most patients can resume normal activities and return to work that is not physically exerting within 1 to 4 days. Patients commonly have the procedure on Friday and go back to work on Monday. Little if any post procedure medication is required for most patients. However, it is important for patients to realize that they have undergone a procedure and should not participate in active competitive sports, heavy lifting or strenuous exercises until they have been released by the physician to do so (usually within two to six weeks).
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Why has fusion surgery received such negative press?
In the early 1950s doctors had no way of identifying what was painful and what was not, and most important, where the pain was coming from. Fusions were done fairly indiscriminately and it was just routine to fuse the bottom two levels and hope the pain would go away. Thus fusion got a bad rap because it was done on a large patient population for which the procedures weren't designed in the first place. If the joint doesn't hurt the patient, then removing the joint motion and fusing it isn't going to help them.
Now we have MRI scans and can easily determine whether or not someone actually needs a fusion. At The Minimally Invasive Spine Institute we have taken that a step further and have a pain mapping process that identifies the exact source of the pain so we work only on the pain source and don't fuse something that doesn't need to be. The Minimally Invasive Spine Institute performs minimally invasive fusion with endoscopic and percutaneous techniques without violating the muscle tissues. The patient will get out of bed and ambulate the same day and will go home as early as the same day or the next day.
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What plans do I need to make to have surgery at The Minimally Invasive Spine Institute?
You will need to bring all medications you are currently taking and have someone available for you after your surgery to either drive you home or stay with you at a local hotel (if you are from out of town). Your patient advocate will assist you in making any and all arrangements required for your procedure.
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If I'm coming from out of town, how long will I have to stay in your area, will I have to come back and what do I need to know?
A minimally invasive procedure is typically performed on an outpatient basis, so in many cases there is no overnight stay at our facility. Many patients worldwide fly in for the procedure and fly out the next day. If you are from out of town, you will need a local hotel room for the length of your stay. There are numerous hotels within a few miles of The Minimally Invasive Spine Institute. Due to the minimally invasive approach, the recovery time has been minimized to a matter of days as opposed to months so no return visit is necessary if you do not wish to. Our office nurses and/or medical assistants will keep in touch with you to check on your progress at certain intervals determined at the time of your procedure.
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What are the risks of minimally invasive spine procedures?
Minimally invasive laser procedure complications are generally very low compared to traditional open back surgery. The Minimally Invasive Spine Institute's doctors always use the smallest incision possible with the procedures, in many cases only requiring a local anesthesia and a Band-Aid®. Typically NO general anesthesia will be required, which can be a high risk for some patients. Post-procedure infection at the incision site is a complication that rarely occurs.
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What is a minimally invasive discectomy?
A minimally invasive discectomy is an outpatient surgical procedure to remove herniated disk material. The procedure may be performed in the operating room or special procedures room. Patients are administered a local anesthesia, consisting of an injection of anesthetic in the muscle (not a spinal block) and also IV sedation. Then, with the help of X-ray fluoroscopy and a magnified video for guidance, a small specially designed probe is inserted through the skin of the back, between the vertebrae and into the herniated disk space. Work is done down the hollow center of the probe to remove a portion of the offending disk. The bulging disk can be pushed back into place and also disk fragments and small bone spurs can be removed. On average, the procedure takes about 45 minutes to an hour. X-ray exposure is not significant. You normally will feel little if any pain or discomfort. Upon completion, the probe is removed and a small Band-Aid® is placed over the very small opening. There are no stitches. The amount of nucleus tissue removed varies, and the supporting structure of the disk is not affected by the procedure. In comparison to the large incisions required for open surgery, the access route to the disk in this non-traumatic procedure consists of only the probe's small opening site, usually the size of a freckle (frequently heals with no trace).
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How is minimally invasive discectomy different from open lumbar disk surgery?
A minimally invasive discectomy is different from an open lumbar disk surgery because there is no traumatic back muscle dissection or cutting, no bone removal, and no significant skin incision. The risk of complications from scarring and blood loss is essentially eliminated with this procedure. Minimally invasive discectomy was invented to be an effective treatment for herniated disks while avoiding these risks.
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Can spinal stenosis or foraminal stenosis be helped?
Yes, The Minimally Invasive Spine Institute's techniques work well for these conditions. The Minimally Invasive Spine Institute can remove impingements to the spinal or foraminal canal and free the nerve, thereby relieving the pain and symptoms that can be debilitating and hinder the life you want to live.
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How many procedures are typically needed to get rid of my back or neck pain?
With many doctors it might take 2 or 3 procedures on different days to solve the pain. But at The Minimally Invasive Spine Institute it typically only requires one procedure. During the first consultation, it will be determined where the damage is located but more important, how many of those levels of damage are actually causing your symptoms. Many times, damage is found at multiple levels, but only one or two of them are causing your symptoms. The Minimally Invasive Spine Institute can perform multiple repairs during the one procedure.
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