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Minimally Invasive Pain Institute

Frequently Asked Questions (FAQs)

Medical

1. What is the difference between Endoscopic surgery (minimally invasive) and traditional surgery?

Endoscopic surgery involves the use of minimally invasive techniques. At MIPI, our trained physicians use advanced techniques to perform various procedures. Where traditional surgery methods involve large incisions, minimally invasive techniques require very small incisions be made to complete the procedure. The advantage of using minimally invasive techniques is our physicians are able to treat spinal pain with very little blood loss and scarring or scar tissue formation. In addition, endoscopic surgery does not involve the use of hardware (metal rods, pins, etc.). This reduces the risk of any potential problems that occur with traditional surgical methods.

 

Minimally Invasive (Endoscopic Surgery)

Traditional Surgery

Incisions

Small

Noticeably large

Blood Loss

Very Little

Significant

Scarring

Very Little

Larger – depends on incision

Scar Tissue Formation

Very Little

More

Hardware

Not used

Used, may lead to other complications

2. What are the risks of spine procedures?

At MIPI, we strive to provide our patients with the best level of care possible. Although it is impossible to eliminate all risks related to any medical procedure, we take precautions to ensure the safety of our patients. The number of surgery complications at MIPI are generally very low when compared to traditional open back surgery. The carefully trained physicians at MIPI are trained to perform many minimally invasive procedures that require no incision. The absence of an incision results in a much lower incidence of complications such as infections and other complications related to wound healing. Furthermore, these procedures do not require the use of general anesthesia, which can cause complications in some patients. Post operative infection at the incision site is a complication that rarely occurs.

 

Minimally Invasive (Endoscopic Surgery)

Traditional Surgery

Incisions – for certain spinal procedures (e.g. spinal cord stimulator)

Small

Noticeably large

Incisions for other procedures 

None

Large

Risks

Very Little

Significant

3. What type of anesthesia is used for these spine procedures?

At MIPI, we strive to ensure the comfort of our patients. During a spine procedure at MIPI, patients are sedated and comfortable throughout the duration of the procedures. After IV sedation, our trained professionals administer a local anesthetic at the surgical site. The use of local anesthetic rather than general anesthetic allows patients the ability to communicate with the surgical team throughout the spine procedure. This provides the patient the ability to relate to the team when pain has been alleviated and a nerve impulse is moving the length of the nerve.

 

Minimally Invasive (Endoscopic Surgery)

Traditional Surgery

Anesthesia used

Local Anesthetic

General Anesthetic

Patient Communication during procedure

Patient can communicate with Doctor during the procedure

Patient cannot communicate with Doctor during the procedure

4. I have spinal stenosis or foraminal stenosis, can I be helped?

Yes. At MIPI, our trained physicians use techniques that work well to treat these conditions. Using various procedures, our physicians remove impingements to the spinal or foraminal canal which frees the nerve, thereby relieving the pain and its accompanying symptoms.

5. How many spine procedures will I require to solve my back or neck pain?

Back and neck pain is different for every patient. Therefore, each patient is given an individualized treatment plan. The number of procedures necessary is determined by you and your physician. During the initial evaluation, your physician will determine how many levels of damage you have which are causing symptoms. Many patients experience pain in multiple areas and levels. However, only one or two of the problems may actually be causing symptoms. Most patients need just one surgery, but many have multiple procedures within that surgery.

Patients who suffer from multiple pathologies concurrently may require a combination of techniques. For instance, some patients may benefit from both a foraminotomy and a laminotomy. These procedures can be done concomitantly by our surgeons so that you are in the operating room only once allowing you to minimize your recuperation, time spent and costs.

6. Can you help me if I have had failed open back surgery?

Yes! At MIPI, our highly trained physicians can help many patients who suffer the consequences of failed back surgery. In fact, a large portion of our patients have had failed back surgery in the past or suffer from new spine conditions due to fusions. At MIPI, our procedures can correct most spinal conditions, plus our highly trained surgeons can remove unwanted hardware that causes additional spine conditions. Our highly trained surgeons can also remove scar tissue development from a previous open back surgery that may also cause new and painful spine conditions.

7. What medications should I avoid prior to having spine procedures?

To reduce the risk of complications, you must stop taking all aspirin or anti-inflammatory drugs (or any combination drugs containing them) two weeks prior to coming for surgery. These medications thin your blood. It is important that the consistency of your blood be as close to normal as possible during your procedures.

Coumadin is a strong blood thinner and if you are on this medication, please consult your doctor about discontinuing it prior to coming for your surgery. If you are taking any other medications, please inform us at the time you are scheduling procedures, so we can advise you about them on an individual basis. Our nurse will give you detailed instructions prior to and after your spine surgery.

8. Can I drive soon after surgery?

We advise all of our patients to have a responsible adult drive them home after the procedure. This is because of the IV sedation and local anesthetic that are administered during the procedure.  However, you will be able to return to normal driving and resume other activities of daily living within twenty four hours after your procedure.

9. How long will I have to wear a neck collar if I have cervical surgery?

Patients who undergo neck surgery are required to wear a cervical collar for the first two weeks after their surgery. Patients are also instructed to wear the collar if they are sitting or walking for extended periods of time (e.g. when working at a desk or driving in a car).

10. What is the difference between the Laminotomy procedure and a Laminectomy?

To open up the spinal canal, our highly trained physicians at MIPI use an endoscopic approach for laminotomies, without the need for general anesthesia. At MIPI, our physicians do not perform laminectomies. A laminotomy is a surgical procedure that is performed to relieve pressure from the exiting nerve root and spinal cord in the spinal canal, and to increase the amount of space available for the neural tissue. The term laminotomy is derived from the Latin words lamina (this is the bony plate which covers the posterior arch of the vertebra) and -otomy (this is the act of cutting, incision). Laminectomy is another type of surgery. Laminectomy is a procedure used in traditional open back surgeries and involves removing the lamina to increase the amount of space available for the neural tissue. The term laminectomy is derived from the Latin words lamina (thin place, sheet, or layer), and -ectomy (removal).

11. An overall comparison between Minimally Invasive Procedures and Tradition Surgery

 

Minimally Invasive (Endoscopic Surgery)

Traditional Surgery

Incisions

Small

Noticeably large

Blood Loss

Very Little

Significant

Scarring

Very Little

Larger – depends on incision

Scar Tissue Formation

Very Little

More

Hardware

Not used

Used, may lead to other complications

Incisions – for certain spinal procedures (e.g. spinal cord stimulator)

Small

Noticeably large

Incisions for other procedures 

None

Large

Risks

Very Little

Significant

Anesthesia used

Local Anesthetic

General Anesthetic

Patient Communication during procedure

Patient can communicate with Doctor during the procedure

Patient cannot communicate with Doctor during the procedure

General

1. How do I find out if I am a candidate for Procedures?

You can go to our Contact Us page and contact us over the phone or submit your information and any questions you may have by e-mail through our website. Someone from our office will contact you at the time and manner in which you request and answer your questions. After that, if you would like a Free MRI Review to determine if you are a candidate for our procedures, all you need to do is fax your MRI Report and one of our health care professionals will review the report, determine if you are a candidate, and call you to discuss your condition and what procedure(s) will help you. It's that easy and at no cost to you for this review and discussion with one of our staff members.

2. If I'm coming from out of town, how long will I have to stay in your area?

This is outpatient surgery, so there is no requirement for overnight stay at our facility. If you are from out of town, you will need a local hotel room for the duration of your stay. There are a number of hotels within 1 mile.  

In most cases you will be required to stay 24 hours after your surgery, before returning home.

3. What, if any, are my limitations after laser spine surgery and how long will I be out of work?

Patients should expect physical therapy to begin the very first day after your procedure. However, it is advised that you limit lifting over 10-15 pounds for about six weeks. We also recommend that patients resume normal activities gradually in order to allow for maximum healing. Patients who have sedentary jobs can typically return to work within a few days. However, patients with physically strenuous jobs should wait six weeks, depending on the job. Patients may return to work with restrictions for those first six weeks and then resume normal activity thereafter.

4. What arrangements do I need to make to have surgery?

We advise all of our patients to have a responsible adult drive them home (if you are local) or stay with you at a local hotel (if you are from out of town) after the procedure. Someone at our office can assist you in making arrangements.

In addition, we ask that you bring all medications you are currently taking.

5. Why don't more surgeons use these types of techniques?

At MIPI, our highly trained physicians take pride in performing sophisticated procedures that are difficult to learn and take years of training. They are on the cutting edge of medical technology and MIPI is at the forefront of this movement. We envision the practice of medicine changing in the future, and that this will become the standard of practice for the surgical interventional treatment of spinal conditions throughout the world. Until then, the highly trained physicians at MIPI are here to help relieve the pain and suffering of people with spine conditions in the most effective, efficient and gentlest methods possible.

6. Why aren't more surgeons using these types of procedures?

Due to the nature of this procedure, a highly skilled and well-trained surgeon is required to utilize the laser as the primary surgical instrument through such a small incision. At this time, many medical schools are not currently teaching the procedures performed by the surgical team at MIPI.  In order to master the technique, a surgeon must be professionally trained by a certified doctor in the specialty of minimally invasive endoscopic spine surgery. The team of skilled and well-trained surgeons at MIPI are constantly learning about the latest, most cutting-edge methods of treating pain to ensure that our patients receive the best care possible.

7. Will my bulging disc or herniation be removed?

If your physician determines that a disc is pressing on the spinal cord or on an exiting nerve and symptoms are present, that portion of the bulging disc or herniation will be removed in order to release the impingement at the necessary level. However, opening or widening the foraminal or spinal canals will alleviate pressure on the nerves without removing any portion of the disc, in most cases.

8. Can anything be done to help the small percentage of patients that do not get any relief?

At MIPI, we follow a multi-step approach. After the appropriate interdisciplinary plan of care is followed for each patient who does not experience relief over a period of time, a re-evaluation may be performed to determine if the patient needs a revision or another procedure. This may involve a diagnosis of an additional level of spinal disorder.

9. How does our surgery differ from that of what is offered by other surgeons claiming they perform the 'laser' technique?

The most prominent difference between MIPI and other spinal centers offering "laser" treatment is the manner in which the procedures are performed. Our highly trained physicians are able to reach the spine using an endoscopic method minimizing trauma to the body, scar tissue formation, and healing time.