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Minimally Invasive Spine Surgery
Dr. Wind trained in minimally invasive spine surgery (MIS) techniques during his residency training, and then spent the last decade honing his practice. He seeks to employ minimally invasive techniques whenever possible in spine surgery, and does this for the majority of his spine surgeries. Many surgeons claim to use minimally invasive techniques by using slightly smaller incisions. But the real rationale behind MIS is avoiding the trauma to the muscles on the back of the spine that is associated with a standard open midline incision. When these muscles are retracted (or pulled to the side off the spine), they never truly recover. This results in many of the poor outcomes associated with spine surgery - blood loss, infection risk, postoperative pain, etc. MIS techniques for spine surgery involve using muscle sparing procedures to avoid these downsides. These techniques have been demonstrated in multiple research studies to have less blood loss, lower infection risk, shorter hospital stays, decreased postoperative narcotic requirements, and shorter return-to-work times.
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For the majority of spine surgeries, MIS techniques involve using a small tube that dilates in-between the muscle fibers of the back to allow Dr. Wind to use a microscope to perform the surgical procedure. When the tube is removed at the end of surgery, the muscle fibers slide back together. Dr. Wind uses this technique to perform a posterior cervical foraminotomy, a lumbar laminectomy, or a lumbar diskectomy.
In addition to these procedures, Dr. Wind performs lumbar fusion procedures through this tubular MIS approach. This is called a minimally invasive transforaminal lumbar interbody fusion, or MIS-TLIF. This surgery is often used when there is a stability issue with the spine in addition to nerve compression. This MIS technique really shows the difference compared with open lumbar spine fusions, which require a large exposure and the associated negative consequences of this.
In addition to MIS-TLIF, when a fusion is required, Dr. Wind also employs several other alternate routes to the spine, such as lateral or anterior approaches which allow access to the spine through corridors that again spare the muscles on the back of the spine. These procedures (Lateral Lumbar Interbody Fusion or LLIF, Oblique Lumbar Interbody Fusion or OLIF, and Anterior Lumbar Interbody Fusion or ALIF) all allow significant correction to the spine for cases of deformity, instability, and nerve compression, while protecting the back muscles from the consequences of traditional open spine fusion surgery.
Many of these MIS procedures allow Dr. Wind to perform surgery through an incision of an inch or less on the back. And while small incisions are appealing, it's more than cosmetics. It's the impact on the underlying muscles that is the true strength of MIS spine surgery.
