Our Summary

This research paper discusses the use of minimally invasive spine surgery for various spinal diseases, not just the traditional use of it for slipped discs. The study looked at patients who had been operated on by one surgeon between January 2019 and April 2023. Anyone who needed their operation to be changed to a more traditional, open surgery was not included in the study.

The study included 47 patients, with a variety of different spinal diseases. The surgery took on average about 2 hours, the average blood loss was around 138 milliliters, and the average hospital stay was about 2 days. Two patients had minor infections on the surgical wound, but none of the patients had any leakage of brain and spinal cord fluid. No patient required further surgery.

The study concluded that minimally invasive techniques for various spinal diseases are as good as traditional open surgeries. These types of surgeries also have additional benefits, such as causing less damage to tissue, allowing for a quicker recovery, and allowing patients to return to work sooner. However, the techniques do require a learning curve for surgeons to become proficient in them.

FAQs

  1. What types of spinal diseases can be treated with minimally invasive spine surgery, according to the research?
  2. What are the benefits of minimally invasive spine surgery over traditional open surgery as per the study?
  3. Were there any complications or need for further surgery after the minimally invasive procedure in the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about detethering surgery is to follow post-operative instructions carefully to ensure proper healing and recovery. This may include avoiding heavy lifting, staying hydrated, taking prescribed medications as directed, and attending follow-up appointments with your healthcare provider. It is important to communicate any concerns or changes in symptoms to your doctor promptly.

Suitable For

Patients who are typically recommended detethering surgery are those who have tethered spinal cord syndrome, a condition where the spinal cord is abnormally attached to surrounding tissues, causing symptoms such as lower back pain, leg weakness, and loss of bladder and bowel control. Detethering surgery is recommended to release the spinal cord from these attachments and prevent further neurological damage.

Other patients who may be recommended detethering surgery include those with spinal cord tumors, spinal cord injuries, or spinal deformities such as scoliosis. In these cases, detethering surgery may be necessary to relieve pressure on the spinal cord, restore proper spinal alignment, and prevent further neurological deficits.

Overall, detethering surgery is typically recommended for patients who are experiencing symptoms related to spinal cord compression or tethering, and who have not responded to conservative treatments such as physical therapy or medication. Patients should consult with a neurosurgeon or spine specialist to determine if detethering surgery is the most appropriate treatment option for their specific condition.

Timeline

Before detethering surgery:

  1. Patient experiences symptoms such as back pain, leg pain, numbness, weakness, and difficulty walking.
  2. Patient undergoes diagnostic tests such as MRI or CT scan to confirm the presence of a tethered spinal cord.
  3. Patient consults with a neurosurgeon or spine surgeon to discuss treatment options, including detethering surgery.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are healthy enough for surgery.

After detethering surgery:

  1. Patient is monitored closely in the recovery room for any immediate complications.
  2. Patient may experience some pain and discomfort at the surgical site, which is managed with pain medication.
  3. Patient is typically discharged from the hospital within a few days after surgery.
  4. Patient is instructed to gradually resume normal activities and physical therapy to aid in recovery.
  5. Patient follows up with their surgeon for post-operative visits to monitor progress and address any concerns.
  6. Patient may experience improvements in their symptoms over time as the spinal cord is no longer tethered.

What to Ask Your Doctor

Some questions a patient should ask their doctor about detethering surgery include:

  1. What is the specific reason for recommending detethering surgery in my case?
  2. What are the potential risks and complications associated with detethering surgery?
  3. What is the success rate of detethering surgery for patients with similar spinal diseases?
  4. How long is the recovery period after detethering surgery and what can I expect during this time?
  5. Will I need physical therapy or rehabilitation after detethering surgery?
  6. Are there any alternative treatment options to detethering surgery that I should consider?
  7. How many detethering surgeries have you performed and what is your experience with this procedure?
  8. What is the expected outcome or prognosis after detethering surgery in my case?
  9. Will I need any imaging studies or tests before the surgery to evaluate my condition?
  10. Are there any specific restrictions or limitations I should follow after detethering surgery to aid in my recovery?

Reference

Authors: Mehrotra A, Singh K, Kanjilal S, Dikshit P, Kumar A, Verma PK, Das KK, Jaiswal AK, Kumar R. Journal: World Neurosurg. 2024 Jan;181:e970-e977. doi: 10.1016/j.wneu.2023.11.022. Epub 2023 Nov 10. PMID: 37951463