St. Vincent Charity spine surgeon Dr. Jeffrey Shall is one of a select few in Northeast Ohio who specializes in minimally invasive surgery to correct spinal disorders. Often referred to as “laser spine surgery” (even though the procedures rarely ever utilizes a laser), minimally invasive spine surgery has many advantages, including shorter recovery times and stronger long-term results, over traditional surgical techniques.
“As I was beginning my career, I quickly saw the advantages to a minimally invasive approach. For many procedures, it is significantly better overall for the patient,” Dr. Shall said. “Over the years, I have worked to stay on the cutting edge of new techniques and technology. This is a unique treatment option that we provide our patients right here at St. Vincent.”
Minimally invasive surgery is used to stabilize the vertebral bones or to relieve pressure on the spinal nerves from conditions such as a herniated disc, stenosis (the narrowing of the spinal canal), bone spurs, or scoliosis. However, unlike traditional “open spine surgery,” minimally invasive surgery allows for a much smaller incision – often less than one inch compared to the 5 to 7 inch incision of traditional surgery – and does not require the surgeon to cut into or traumatize surrounding muscle tissue.
This translates to significant benefits to the patient. Patients typically experience less blood loss during surgery, a reduced risk of infection and post-operative pain, faster recovery times, and a decreased reliance on pain medicines. The largest benefit, Dr. Shall said, is the preservation of muscle tissue around the spine.
“The huge advantage to minimally invasive surgery is the fact it destroys less muscle in the spine,” he said. “I have looked at MRIs of patients after both minimally invasive surgery and traditional surgery and saw a striking difference. With traditional surgery, you frequently see dead muscle along the spine, where you do not with a minimally invasive approach. Once the muscle is dead, all that is left is nonfunctioning scar tissue which can ultimately lead to pain.”
Because spinal nerves, vertebrae and discs are located deep inside the body, any spine surgery requires the surgeon to move a patient’s muscle tissue to access the affected area. With traditional open surgical approaches, surgeons make a 5 to 7 inch incision and then may have to cut, pull or “retract” muscle and surrounding tissue to see the surgical site. This pulling of the muscle significantly increases the risk of tissue damage.
For his procedures, Dr. Shall makes a small incision and then inserts a tube, or tubular retractor, through the muscle and soft tissue down to the spinal column. Creating a tunnel to the damaged spine, the tube holds the muscle open instead of cutting or retracting the tissue. The entire surgery, including the insertion of surgical instruments, screws and rods, is performed through the tube. Once the surgery is complete, Dr. Shall removes the tubular retractor allowing the muscles return to their original position. The result is significantly less muscle damage compared to traditional surgery.
“Because the surgery is much less disruptive to the patient, they are able to go home much earlier as well,” Dr. Shall said. “Many can go home same day of surgery or the next day, compared to 3 to 5 days stays for traditional surgeries. Not every spine surgery can be done this way, but for those that are appropriate, this technique brings the best results and comfort for patients.”