Minimally invasive spinal surgery leads to better patient outcomes

Dr Jaytesh Pillay, an orthopaedic and spinal surgeon, performed Mediclinic Kloof’s first minimally invasive spinal surgery in March this year. He explains the benefits for patients.

Spinal surgery – the facts and fiction

Following his groundbreaking minimally invasive spinal procedure, Dr Pillay says he’s happy to be pioneering the use of such techniques at Mediclinic Kloof. He has since performed this surgery several more times with great success. “As the technology evolves, companies have started bringing more advanced equipment into South Africa, which has now allowed us to do minimally invasive spinal surgeries,” he says.

Dr Pillay is keen to dispel prevailing stigmas and myths about spinal surgery. “You hear people say you’ll never get better, or the pain doesn’t go away, or you’re going to end up in a wheelchair. But the truth is that spinal surgery, if done correctly and for the right reasons, is usually successful.” He cites medical studies that show certain spinal surgeries offer the best quality of life outcomes when compared to other orthopaedic surgeries.

This is especially true when minimally invasive techniques are used. “Minimally invasive spinal surgery is the more progressive way to do spinal surgery,” he says. “In these surgeries, we’re using smaller cuts or incisions, special retractors, and less muscle dissection, all of which cause less trauma to the spine.”

Quicker recovery, better patient outcomes

The fact that minimally invasive spinal surgery results in less spinal trauma means patients recover more swiftly, Dr Pillay explains. “Theatre time is faster, there’s less blood loss during surgery and therefore fewer complications afterwards. You can get back to normal life faster than with traditional surgery.” Gone are the days when patients lay in bed for six weeks following spinal surgery. “We often get patients out of bed and start walking them on the same day of the surgery.” Hospital stays may be as short as three days.

While full recovery takes six weeks, this period is steadily decreasing. Many patients feel much better after two weeks, with some returning to some form of work at that point. Patients are also becoming more self-sufficient at home and need only one physio session after two weeks instead of home care and numerous follow-up appointments as they would have previously.

Much like you might upgrade your cell phone regularly in line with advancing technology, surgical techniques are constantly evolving, Dr Pillay remarks. This evolution is leading to higher surgical success rates. “You have to remember that minimally invasive surgery involves the same procedure, but with a different, less traumatic approach,” he says.

Mediclinic Kloof’s first minimally invasive spinal surgery

The first minimally invasive spinal surgery at Mediclinic Kloof took place in March this year. “The patient was in her 60s. She had a history of back pain with leg pain, and it got to a point where she couldn't manage her life,” says Dr Pillay. Before considering surgery, she’d been treated with more conservative methods such as physiotherapy, biokinetics and pain injections. The surgery was a last resort.

“The surgery itself was relatively uncomplicated and all went well,” Dr Pillay says. “She was walking on the same day. Considering it was a first at Mediclinic Kloof, it was exciting for our theatre staff and nurses, who were eager to see what the surgery was all about.” It was a learning curve for the team, but they adapted quickly.

They’ve since performed multiple minimally invasive spinal surgeries. However, Dr Pillay gives his patients the option of doing surgery the traditional way or the minimally invasive way, explaining the pros and cons of each. “We make a decision together as to which one will have a better outcome for the individual.”

Who qualifies for minimally invasive spinal surgery?

“We always ensure patients have tried all kinds of conservative treatments before doing surgery,” Dr Pillay explains. For now, the minimally invasive spinal surgery approach focuses on lower-back problems in patients of all ages and body types. “There must also be some sort of sciatica (nerve involvement), which leads to pain going down to the leg. We usually do an MRI scan and if we find nerve compression, then we know minimally invasive surgery may work.” Patients who injure their spines in accidents are also good candidates for minimally invasive surgery, he adds.

However, the minimally invasive approach is not recommended for patients who have severe nerve compressions on multiple levels, or have already had numerous open spinal surgeries, because they have very different pathologies.  

The future of minimally invasive surgery lies in the use of navigations and robotic surgery, Dr Pillay adds. “These will further streamline the surgical process and be of even more benefit to the patient.”