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Minimally Invasive Spine Surgery (MISS) is a broad term covering several different surgical approaches, but all are designed to access the spinal column while avoiding substantial damage to the surrounding tissue that occurs during open surgery. Patients require much less anesthesia during minimally invasive surgeries or even can be treated with analgesic sedation, so the patient is conscious during surgery and the surgeon is able to see directly the patient's reaction to possible pain.

Am I a good candidate for MISS?

If your back or neck pain has persisted for 6 to 12 months despite trying numerous non-operative treatments, then MISS may be for you. It treats specific conditions such as spinal stenosis, sciatica, spondylolisthesis or herniated discs that can be pinpointed using various diagnostic and imaging tests. "Certain spine conditions require standard ‘open' surgery using longer incisions, such as high-degree scoliosis, tumors and some infections," he says.

How is MISS performed?

The technology used in MISS is compelling, Dr. Bitan says. Using cuts of only an inch or less in length, surgeons access the spine using small tools called retractors, which are placed into the tiny incision and through soft tissues to the designated spot on the spine. Any bone or disc material removed comes through the retractor, and any devices necessary for fusion procedures – which fuse together painful vertebrae so they heal into a single, solid bone – are also inserted through this space. Since such a small incision is used, the surgeon doesn't have to move, remove or alter major muscles, normal bone structures, or nerve bundles. Most MISS procedures take 90 minutes or less.

How quickly will I recover from MISS?

Faster than you think, Dr. Bitan says. Because MISS is minimally disruptive to tissues surrounding the spine, the procedure is often done on an outpatient basis and recovery is swift. Many patients are able to get up and walk right after surgery with minimal pain and go home within a few hours (spinal fusion surgeries may require a 2-3 day hospital stay). Going back to work can occur within 1-2 weeks or just slightly longer, and some patients return to full activity within 6 weeks.

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