MINIMALLY INVASIVE SPINE SURGERY

Until recently, all spine surgeries were performed with traditional open surgery. With the advances in surgical instruments, surgical techniques, biotechnology products, implants and imaging systems, “Minimally Invasive Spine Surgery” procedures can now be safely performed for almost all spine problems.

ENDOSCOPIC SPINE SURGERY

Endoscopic spine surgery is a minimally invasive surgical procedure. In other words, it is a surgical procedure performed through a very small skin incision. Endoscopic spine surgery is used to treat herniated intervertebral discs that cause low back and leg pain, or stenosis in the holes where the nerve roots exit in the spine, causing nerve compression. The holes called foramen where the nerve roots exit and the lateral recess, which is a special region, are enlarged, thus relieving the pressure on the nerve roots and providing relief to the patient. The endoscope allows the surgeon to reach the targeted area through a keyhole-sized skin incision. For this reason, this procedure is also called “keyhole surgery”. While reaching the targeted tissue, the surrounding soft tissues and muscles are expanded with tissue expanders instead of being cut. This results in less tissue damage, less postoperative pain, faster recovery, earlier rehabilitation and eliminates the need for general anesthesia. Thanks to the clear image obtained with the endoscope, the surgeon can remove only the herniated disc fragment or relieve the spinal cord and nerve roots from pressure without damaging the intact tissues. Detailed information about endoscopic spine surgery is described in the relevant sections.

MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION (MI-TLIF)

It allows access to the disc through the foramen with the help of special tissue openers. After a single-sided discectomy, a cage placed between the vertebral bodies allows fusion.

Pedicle screws and posterior instrumentation and fusion are also performed through the same incision, allowing both anterior and posterior fusion of the spine through a single incision from the back. All these procedures can be performed through 4-5 cm incisions. This technique is also performed by us endoscopically through 4 1.5 cm incisions.

DIRECT, LATERAL (EXTREME), OBLIQUE INTERBODY FUSION (DLIF-XLIF-OLIF)

It provides direct access to the spine with a lateral approach and can be safely performed with small incisions made with the special tissue openers used. It provides a significant deformity correction especially in adult scoliosis patients. This procedure can also be performed endoscopically through a 2 cm incision.

MINIMALLY INVASIVE ANTERIOR LUMBAR INTERBODY FUSION (MI-ALIF)

It is a technique based on accessing the spine and disc through the abdominal cavity. Through a single 4 cm incision in the anterior abdomen, the targeted area is minimally invasively accessed. After discectomy, fusion is applied with the help of specially designed cages. It is usually supported from the back with pedicle screws or facet screws applied percutaneously minimally invasively.

PERCUTANEOUS PEDICLE SCREW APPLICATION

Pedicle screws are inserted into the spine with the help of 1.5 cm incisions made in the skin and special tissue openers under fluoroscopy control. This method can be used to stabilize spinal fractures or as an adjunct to other methods.

THORACOSCOPIC DISCECTOMY, MINIMALLY INVASIVE DISCECTOMY

Thoracic disc herniations are extremely rare, but symptomatic discs may present with severe neurologic sequelae if left untreated. In these cases, discectomy is traditionally performed through the back of the spine or by opening the thorax (transthoracic). In thoracoscopic discectomy, which is a minimally invasive method, several 1.5 cm incisions are made in the chest wall and the entire procedure is safely performed using imaging-camera systems and special sets. The same procedure can also be performed minimally invasively through a 4 cm incision with special retractors.

THORACOSCOPIC ANTERIOR RELEASE FOLLOWED BY POSTERIOR CORRECTION AND INSTRUMENTATION IN SCOLIOSIS

In surgical treatment of scoliosis, only posterior instrumentation and fusion from the back of the spine is usually sufficient, but in very advanced and severe deformities, anterior release can be combined with posterior instrumentation and fusion. We perform thoracoscopic anterior release (using imaging-camera systems and special sets and 4 mini incisions) in such severe cases.

PERCUTANEOUS VERTEBROPLASTY-KYPHOPLASTY

It is used as a pain treatment for osteoporotic spinal fractures that do not respond to conservative treatment and for metastases of tumors to the spine. Percutaneous transpedicular access to the vertebral body is performed and a specially designed bone cement is injected into the vertebral body for mechanical support and pain relief.