Minimally Invasive Spine Surgery (MISS)

Minimally Invasive Spine Surgery

When facing spinal conditions that require surgical intervention, the advent of minimally invasive spine surgery has brought new hope to patients seeking effective treatments with reduced invasiveness. In this article, we will shed light on what minimally invasive surgery is, explore its applications in spine surgery, and discuss the pros and cons to help patients make informed decisions about their treatment options.

What is Minimally Invasive Spine Surgery?

Minimally invasive spine surgery (MISS) is a specialized surgical technique used to treat various spinal conditions with minimal disruption to surrounding tissues. Unlike traditional open surgeries that require larger incisions and more extensive tissue dissection, MISS involves making smaller incisions and using specialized surgical instruments, cameras, and real-time imaging technology to access and treat the affected area.

During minimally invasive spine surgery, the surgeon navigates through the small incisions to access the spine, avoiding the need to cut or detach large muscles and soft tissues. Instead, they use advanced tools, such as endoscopes or tubular retractors, to gain a clear view of the surgical site without the need for a wide-open exposure.

Examples of Minimally Invasive Spine Surgeries

  • Microdiscectomy: Microdiscectomy is a common MIS procedure used to treat herniated discs in the spine. Through a small incision, the surgeon removes the portion of the herniated disc that is pressing on the nerve, thereby alleviating pain and restoring normal nerve function.
  • Minimally Invasive Lumbar Fusion: This procedure is employed to treat conditions such as degenerative disc disease and spondylolisthesis. It involves fusing two or more vertebrae together to stabilize the spine and reduce pain. The surgery is performed through small incisions, and bone grafts are used to facilitate fusion.
  • Vertebroplasty and Kyphoplasty: These procedures target spinal compression fractures caused by osteoporosis or trauma. They involve injecting bone cement into the fractured vertebrae to stabilize and restore height to the affected area.
  • Foraminotomy: Foraminotomy is used to relieve pressure on spinal nerve roots caused by narrowing of the foramina, the bony openings through which nerves exit the spine. The surgeon enlarges the foramina through small incisions, providing more space for the nerves.

Benefits of Minimally Invasive Spine Surgery

The benefits of minimally invasive spine surgery (MISS) are numerous, making it a preferred choice for many patients seeking effective treatment for spinal conditions. Some of the pros of minimally invasive spine surgery include:

  • Reduced Tissue Damage: MIS techniques cause less disruption to muscles and tissues surrounding the spine, leading to shorter recovery times and less postoperative pain.
  • Smaller Incisions and Minimal Scarring: Patients benefit from smaller incisions, resulting in less visible scarring and a reduced risk of wound-related complications.
  • Faster Recovery: Since MIS is less invasive, patients typically experience quicker recovery times, allowing them to return to daily activities sooner.
  • Lower Infection Rates: The risk of infection is reduced due to smaller incisions and decreased exposure of internal tissues to external contaminants.
  • Less Blood Loss: The precise nature of MIS results in decreased blood loss during surgery, reducing the need for blood transfusions.

Drawbacks of Minimally Invasive Spine Surgery

Although MISS has many potential benefits, it’s important to understand that it has some drawbacks worth considering. These include:

  • Limited Applicability: Not all spinal conditions can be treated using MIS techniques. In some cases, traditional open surgery may still be the preferred option.
  • Skill and Training: Minimally invasive procedures require specialized skills and training, and not all surgeons are equally proficient in these techniques.
  • Prolonged Surgery Time: Some MIS procedures may take longer to perform than traditional surgeries, although the benefits usually outweigh this drawback.
  • Radiation Exposure: Procedures involving real-time imaging may expose patients and medical staff to some radiation, although the levels are generally safe and controlled.


Minimally invasive surgery (MIS) is a specialized surgical technique that allows surgeons to perform complex procedures with smaller incisions compared to conventional open surgeries.

While minimally invasive spine surgery offers numerous benefits, it may not be suitable for every patient or every spinal condition. The decision to opt for MISS depends on factors such as the specific diagnosis, the extent of the problem, and the surgeon’s expertise.

Patients considering spine surgery should consult with a qualified spine surgeon to discuss their individual case and determine the most appropriate treatment approach.

About the Author

Dr. Luke Macyszyn

Dr. Luke Macyszyn is a Board Certified, fellowship trained neurosurgeon that specializes in the surgical treatment of complex spinal disorders such as scoliosis, spinal deformities, and spine tumors in children as well as adults. Dr. Macyszyn currently practices as DISC Sports and Spine Center. He also holds an appointment as an Associate Professor of Neurosurgery at Saint John's Cancer Institute. Prior to joining DISC, Dr. Macyszyn held appointments at UCLA in the Department of Neurosurgery, Orthopedics, and Radiation Oncology. Dr. Macyszyn completed medical school at Boston University and residency at the University of Pennsylvania.