Minimal access spinal surgery (MASS) or more commonly known as ‘keyhole surgery’ has been developed with the aim of reducing ‘collateral damage’ to muscles, ligaments and soft tissues that is typically associated with traditional open spinal surgery whilst obtaining the same clinical outcomes of traditional open procedures.
The technique has been developed to complement minimal invasive spinal surgery (MISS) as this often does not allow for direct visualisation of the spine. In that regard both of these techniques DO NOT alter the indications or goals of surgery.
Depending on the condition being treated, a mini-open exposure reduces the size of the wound to approximately 2 to 5 cms long, and with the aid of a self retaining frame-based retractor allows for a complete exposure of the desired area of the spine.
Both MISS and MASS can be employed to treat sciatica, disc herniations, spinal stenosis, disc degenerations, tumour, trauma, tumour, infection, scoliosis, and kyphosis. Surgeries range from discectomy, decompression, disc replacement, anterior spinal fusion (ALIF), posterior spinal fusion (PLIF and TLIF), and anterior-posterior spinal fusion (AP fusion). During spinal fusion, pedicle screws and interbody cages can be effortlessly placed into the spine with the use of X-ray control and with minimal tissue damage.
The major benefits of MASS and MISS include:
- Reduced post-operative incision pain
- Improved mobilisation
- Reduced blood loss
- Minimised respiratory difficulties
- Early discharge from hospital (often as day surgery in regards to discectomy, decompression and some types of spinal fusion)
- Enhanced rehabilitation and early return back to activities and work
With significant advances in modern day instrumentation and surgical techniques, there is a limited role for traditional open spinal surgeries.